Epididymitis without vaginal, anal, oral sex

[stephenh]

Several days ago I noticed a dull pain around my right testicle around four hours after an unresolved erection during interrupted intercourse with my partner and an hour after a four mile run.  The pain appears to come from the epididymis where there is some swelling and tenderness.  The testicle appears to be mostly unaffected.  There was some burning during initial urination after noticing the pain and after showering using a new soap?

Eleven days prior to the onset of pain, I engaged in mutual masturbation with a new female partner.  After touching her vagina with my hand only, I wiped my hand off before it came into contact with my penis.  While my penis touched her body and hands, it did not come into any contact with her vagina or anus.  My hand had only minimal contact with my penis for a number of minutes and after being dry.

I am 40 years old with no history of known urinary problems.  The pain and swelling appear to be decreasing now on the third day after the sudden onset.  There has been no further burning upon urination.  There has been no discharge or itching of the uerethra either.

The question is whether or not there is risk of the epididymis pain being caused by chlamydia or gonorrhea from this casual encounter?

Thanks

[Edward W Hook, MD]

Is the pain on the outside of your scrotum or the inside?

Epididymitis can occur in persons of your age as a result of either STD acquisition or due to the organisms that cause urinary tract infection (in men under 30 it is almost always and STD). In either case, this is a serious infection which needs to be tested for and treated.  Please see a health care provider ASAP.  Please let me know what your health care provider says- I given your history, I would probably treat you for both STDs (particularly chlamydia) and urinary tract organisms while waiting test results unless some other diagnosis came to mind following examination.

Hope this helps.  EWH

[Edward W Hook, MD]

Just re-read the title of your post.  I answered based on your text in the question but just looked at the title again.  What do you mean by "without vaginal..." in the title?  Your post says you had sex but did not complete the act.  

EWH

[stephenh]

Sorry.  I should have been more clear.  The "without vaginal..." refers to the casual encounter with mutual masturbation.  The vaginal intercourse with my usual partner is not suspect for STD infection, meaning I am entirely confident that she has not had other partners in a decade.  Thus my question.  The pain is inside my scrotum.  Swelling of the epididymis (my own estimate of area) has subsided significantly in the last 24 hours.  

I am seeing a urologist tomorrow and will have him take a look.  My STD question regarded the mutual masturbation episode which you have previously categorically discounted for HIV transmission, but there appears to be some mention on the web of potential for chlamydia or gonorrhea (leading causes of epididymitis in younger men).

[Edward W Hook, MD]

Thanks for the clarification.  There is no risk to your for gonorrhea or chlamydia from mutual masturbation.  Seeing your urologist is the right thing to do.  EWH

[stephenh]

I realize this follow up is very late.  I did not mention that I had a vasectomy performed about a year ago.  Does a vasectomy change the possibility or probability of epididymitis as a result of an STI?  

[Edward W Hook, MD]

Thanks for the follow up.  I am not a urologist and do not perform vasectomies or see many complications of them  With all due respect, this question might be better directed to your urologist.  I do not think the fact that you've had a vasectomy should change things much.  EWH