Help Dr Hansfield, please

[Garfield1234]

Dear Dr Hansfield

I am writing to you out of sheer desparation and hope.  Firstly, I hate myself for my mistake and would do anything to turn the clock back.  On May 5th 2011 I had very brief unprotected oral sex with a sex worker (I am male).  I have had no symptoms at all since.  Now, over 3 months on and after being logged onto medhelp for weeks, I have either got burning pee or I have convinced myself I have it (I am very sure of always thinking the worst and being paranoid).  I do not have discharge.

I am petrified I have made the bigget mistake of my life (I am married).  

What is the likely situation I am in?

Please help me.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  FYI, and so other readers understand, it is only by chance that I am answering your question rather than Dr. Hook.  We ignore requests for one of us or the other, and just take questions more or less randomly.  Our opinions and advice are always pretty much identical, even if our writing styles are somewhat different.

You have had repeated reassurance about this even on the community forum.  You had a low risk exposure, since oral sex is quite safe -- not completely without STD risk, but much less than for vaginal or anal sex.  And virtually all STDs from oral sex would cause symptoms that you don't have:  discharge form the penis and/or penile sores.  The urinary discomfort you describe sounds psychological, which you obviously are inclined to believe yourself.

One of your comments on the community forum indicates you haven't been tested because you are afraid of the result.  That is absolute nonsense and I have no patience for it.  Testing doesn't give someone an infection; you have an STD or your don't.  And if you do, of course you need to know in order to be treated.  For the reasons above, it is very unlikely you caught anything, but testing is the only way to know for sure.  So just suck it up and do it.  I'll be happy to comment further if and when you have been professionally evaluated and your test results are available -- but I will have no further comments or advice until then.

Regards--  HHH, MD

[bigwreck]

As a fellow sufferer from STD anxiety, I urge you to take Dr. Handsfield's advice and go get tested by a knowledgeable health care provider.  You will never ever know for sure just by reading the internet and asking questions here.  And with not knowing for sure, your mind will never let go of this.  Go get tested, and when the results are negative, believe them.

I say this out of compassion.  I've been there.

[H. Hunter Handsfield, M.D.]

I'm unaware of any home self tests for gonorrhea; none are approved by the Food and Drug Administration for use in the US.  However, if you collected a swab and sent it to a central lab, the test result probably is valid.  That said, I am disappointed you tried to test yourself rather than visiting an STD clinic or other clinic or doctor.

As for your symptoms, it is not uncommon for prostate gland secretions to be squeezed out during defecation.  See these threads:

http://www.medhelp.org/posts/STDs/Semen-Leakage-Question/show/684727
http://www.medhelp.org/posts/STDs/Semen-Like-Discharge--STD/show/427617

[Garfield1234]

.I need to add this was at the end of a bowel movement which was very tough and needed straining.  Could this be interlinked?  God, I hope so.

[Garfield1234]

Doctor, today I took a home swab test for gonnorhea which came negative.  But I just urinated there and for the 1st time I noticed what looked like watery clear semen with tiny jelly like blobs at the end of the stream of urine.  What could this be?  Please help me, I thought I was over this and straight away something else happens to me.

[H. Hunter Handsfield, M.D.]

I saw this before replying.  It makes no difference in my opinion or advice, except that the brevity of exposure makes it especially unlikely you caught any STD.

[Garfield1234]

I meant to say that my exposure was well under 30 seconds and non vigorous, and also that I have no sores or anything.  I have spent the past few weeks focussing all my thoughts on my genital area and any tiny twinge or anything is blown up in my head, rightly or wrongly.  I am sorry I didnt add this before.