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Chances of gonorrhea or NGU infection?

I had an incident 3 days ago in a massage parlor where I had a girl lick my testicles, masturbate me using saliva as a lubricant, and (I'm not sure but I think) place the tip of my penis in her mouth (just the tip).  The penis insertion would have only been just past the lips and teeth and would not have gotten close to the back of the throat (less than 5 seconds).

Since this time I have had feelings of guilt and remorse and have been urinating frequently constantly on the lookout for any symptoms.  I have noticed some minor discomfort before during and after urination but mainly when I'm concentrated on it (been scouring this form for a few days now).  I have noticed no discharge.  Since this occurrence I have had sex twice and masturbated 3 times with minimal lubrication (possible cause of discomfort?).

Questions:

1) Does the penis need to touch the back of the mouth/throat region in order to realistically run a risk of Gonorrhea or NGU infection?
2) Does length of exposure make a large difference in risk for Gonorrhea/NGU infection?
3) After 3 days (4 days if you guys are taking off New Years Day) would most people have developed secretion from NGU or Gonorrhea?

I appreciate your work on this forum.  I am especially interested in question #1 since in other posts I've seen you refer to licking of the shaft and testicles as equivalent to  the licking of an elbow and have seen statements that state that insertion is required and that these bacterial infections live at the back of the throat.

If it matters and kind of a #4, I've received unprotected oral on many occasions not resulting in an NGU, would this indicate lack of susceptibility to what you have frequently called NGU caused by everyday mouth bacteria?
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300980 tn?1194929400
MEDICAL PROFESSIONAL
Your summary statement is correct.  You did not become infected and you do not need further testing.  

I agree that at this time your symptoms are more likely to be due to repeated self examination and increased attention to the area than anything else.  

About 10% of gonorrhea does not present with discharge.  The figure for NGU may be a bit higher.  Either way however, you were tested.  Believe the tests.

You did not need the azithromycin.  The dose you took however would be effective for gonorrhea and NGU.

EWH

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Avatar universal
One last comment, and then your closing remarks please.  After my test I did take 2g of Azithromycin (one dose).  I had sex with my wife that night (which I don't think should be too big of a deal with that amount of antibiotic in my system) and then this morning she took 1g of Azithromycin and will take another 1g tomorrow.  Assuming we don't have sex for 6-7 days this should clear up any possible infection that would be there, correct?
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Avatar universal
So just to confirm and close this string.  Am I correct in saying that based on the low level exposure and the results of the urinalysis that your professional opinion would be that no further testing is needed and that I did not receive an NGU or Gonorrhea infection?  

The mild irritation of the urethra remains but I'm thinking this is likely to the fact that I've thought about it and urinated every 2-3 hours for the last few days while constantly checking the urethra for obvious signs of red irritation or any pus (neither of which have appeared now 6 days later).

Another question which may not be cut and dry but I would appreciate your best guess.  What percentage of gonorrhea/NGU cases DO NOT present with some sort of discharge?
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300980 tn?1194929400
MEDICAL PROFESSIONAL
Yes.  EWH
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Avatar universal
Dr. Hook.  I did a urinalysis this morning (5 days after the incident) and it showed nothing except:

Leucocites:  3
Epithelial Cells:  scant trace

Everything else was not there.  Would you consider this normal?  
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Yes, the urinalysis looks for white blood cells.  EWH
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Avatar universal
Dr. Hook, would a standard urinalysis that came back clean (no white blood cells or epithelial cells) indicate lack of infection with a fairly high probability when it comes to Gonorrhea and NGU?
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL

Welcome to our Forum.  You are asking good questions which are a bit difficult to address since it is so difficult to study how sexual activity might vary in the course of any specific encounters (or to use a colloquialism, "there are different strokes for different folks"). Before I answer your specific questions however, a few general statements.  First and most importantly, the only way for you to really know if you have NGU is to be examined by a trained clinician who will test either a swab specimen secretions from your penis or urine collected just as you begin to urinate for white blood cells.  While urine and other sorts of specimens can tell you with great precision if you have gonorrhea or chlamydia, since most NGU is not caused by chlamydia, the only way to know for sure is with the testing I mentioned above.  In your own case, this may be important since you could have transmitted your NGU to your sex partners since your exposure to the CSW.  

Let's address your questions:

1. There are no ata to say that the penis must contact that back of the throat to acquire gonorrhea or NGU during oral sex.  I would presume that it is not necessary.
2.  Common sense tells us that the longer the exposure the more likely that transmission is to occur but as I mentioned above there are no studies of this and time estimates regarding the duration of sex are notoriously variable.
3.  Symptoms of STDs such as gonorrhea an NGU rarely occur in the first day or two after exposure.  They can certainly develop on at 3 or 4 days.  
4. Most exposures do not lead to infection.   It is a chance event. That you have not gotten NGU from oral sex before does not mean that you cannot get it.
5. Finally , the myth is that the pain on urination associated with gonorrhea, chlamydia or NGU should be severe. That is not the case however. The discomfort can be quite mild.

Bottom line, to know you need to be tested. My guess is that you did not get infected but you will not know without testing.

Happy New Year.  EWH
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Avatar universal
Also, when they talk about Burning/Pain when urinating.  I know that not all peoples symptoms are the same, but normally is that a very strong burning or pain or is it frequently just a minor discomfort?
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