Further testing needed?

[biggestfool]

Had unprotected oral exposure with CSW at a massage parlor for 15-20 seconds before a condom was placed on and proceeded to finish with protected vaginal sex.  Am primarily concerned about exposure from brief oral exposure.  A few days after incident, had unexpected surgery for which mefoxin was administered.  I noticed it is supposed to cure "uncomplicated" ghonorrea.  On the low chance I would have picked up anything from the oral exposure, would the mefoxin have adequately cured it?  It has been almost 3 weeks since exposure and 2 weeks since receiving the mefoxin, and I have had no discharge, no pain while urinating etc.  Just the typical anxiety as I have a partner who I am worried about passing anything along to and have been refraining from having sex with since the exposure.  Absent symptoms and with the mefoxin, is there a need for me to get any testing?

[Edward W Hook, MD]

I am not sure what caused your discomfort however I am confident it does not represent an STI.  EWH

[biggestfool]

Your comment is helpful.  One last question.  Over the last 3 weeks, I have abstained from any type of sex.  Yesterday I resumed sex with my partner, and no issues.  However, today I masturbated an experienced a sharp, shooting pain in my right testicle for about 5 seconds.  Could this be sign of an infection, or a result of abstaining so long from sex?  Thanks!

[Edward W Hook, MD]

Welcome back to the Forum.  I'll be happy to provide some information that I hope will help you decide about further testing.  I agree with you that your STI risk related to the exposure you describe is limited to the potential problems which might follow receipt of oral sex.  Fortunately, oral sex is an inefficient way to transmit STDs.  Even among persons with many sex partners, oral infections are uncommon and for a number of biological factors too complex to go into here, the efficiency of transmission of infections through oral sex is lower than for penetrative genital-vaginal or –anal sex.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; for all practical purposes, chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.  In addition cefoxitin (Mefoxin) would be expected to cure most gonorrhea in the unlikely circumstance that you acquired it.  If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection).  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  In your case, your exposure was brief, you received antibiotics and you are now without symptoms two weeks out from the exposure. he chances that you have a STI from this event is low.  If I were you, I would not worry however the decision for testing is ultimately up to you.. If you choose to, you could go to your local STD clinic or health care provider to be tested at this time.  If you do, I anticipate that the tests will be negative.  

I hope this comment is helpful.  EWH