Help me Doc

[reallyterrified]

I recieved unprotected oral(about 20 minutes worth) and protected vaginal sex from an escort 8 days ago. The head of my penis , at the base was very sore (burning itching)and I had difficulty urinating immidiately afterwards and that symptom has continued. 2 days ago I went to the doctor and had a screening for Chlamydia and Gohnarrea as the urination problems had continued.I am awaiting those results.2 days ago I also started sweating at night but I have no fever. . I have no visible lesions on my penis, there is some redness at the base of my "head" but it is subsiding and has just about disapeared, although I did have some tingling itching on my scrotum also but this felt like it was on the surface skin not the testacles themselves. I am experiencing diahrea but I am really scared so i am thinking this could be anxiety. Do you think I have contracted herpes and could you tell me the proper testing times and process as I have a wife and dont want to cause her any health issues because of my stupid mistake. thank you.

[H. Hunter Handsfield, M.D.]

Neither herpes nor any other STD can cause pain, soreness, or urinary "difficulty" immediately after sex; those symptoms had to be some sort of trauma or irritation from the sexual exposure itself.  Also, herpes does not generally cause redness without visible lesions, nor does it cause itching or tingling of the scrotum or anywhere else.  You cannot catch gonorrhea or chlamydia through a condom, nor chlamydia from oral sex -- testing for those things might have made sense just to be safe, but if they had been positive, it would have come from some exposure before the escort event you are concerned about.  Finally, as you suggest yourself, diarrhea certainly can be an anxiety symptom -- and when a person suspects his or her own symptoms are due to anxiety, usually they are correct.

I never guarantee someone isn't infected.  But from all you describe, I very much doubt you have herpes or any other STD from the escort exposure.  Continue to follow-up with your provider if your symptoms persist.  But if they fade -- as they probably will -- I would just let it go and move on.

Good luck--   HHH, MD

[reallyterrified]

The tests for Gohnarhea and Chlamydia came back Negative. There was no other exposure other than my wife for 15 years. I am experiencing testicular pain right now ( 2 on pain scale) and a weak urine stream but the itching of my "head" is and subsiding and less pain when urinating(also a 2). I still have the Diarrhea. I do appreciate your reassurance regarding herpes. My only other question is there anything else to be concerned with? What is the incubation period of Syphillis and exposure risk for my unprotected oral (It was not to completion) .I will wait the appropriate amount of time and get tested for Herpes(just for my anxiety). It almost seems like I damaged myself. My wife and I do not use condoms. Perhaps it is a friction burn or UTI caused by spermicidal condoms.

[H. Hunter Handsfield, M.D.]

You could have caught a garden-variety gastrointestinal virus from the escort (anybody close enough to have sex is of course close enough to catch any nonsexually transmitted infection the partner may have.)  Other than that, I truly believe you have nothing you caught from the escort.

Syphilis is rare, with only about 20,000 cases per year in the entire US, three quarters of them in gay men.  And syphilis doesn't cause any of the symptoms you describe.

I have no other ideas or advice.  If your symptoms persist or you remain concerned, continue to follow-up with the provider who did the STD tests, or with your primary care provider (if they aren't the same person).

[reallyterrified]

Doc, It has been 21 days from the time of my encounter. I am having lower back pain(not in my tailbone) The pain of urination is still there but I have been having it for what seems like so long that its itensity is hard to really compare, the diarhea (diarrhea) has been off and on. I have no fever. The redness and itching of the Corona is still there.I am also still having  pain in the testicles themselves  I almost think that a new spot of redness has appeared but is very small. I am also having some pain below my testicles - but not a hemroid kind of thing. It just feels like I gotta go or i "pushed too hard" I have also had what seems like pain in my kidneys/and some general abdominal discomfort- have also had a couple more night sweats episodes.I am making an appointment with my PCP tommorrow. Is prostatitis a possibility? I am still terrified about herpes. Although no white lesions/blisters and no scabbing. I also still dont have any penile discharge. My questions is this. What tests can be performed at this stage to quell my fears about herpes?  I want to know what to ask for. Thank you for your previous insights.

[H. Hunter Handsfield, M.D.]

You describe no symptoms that suggest any STD, and that's as far as this forum goes.  Just keep the appointment with your PCP and follow his or her advice.  However, you should be prepared for the good chance that s/he will think your symptoms are primarily due to anxiety.  They certainly sound to me like they have an emotional rather than physical basis.

Since you ask about prostatitis, I will say that I doubt it.  However, you might google "chronic pelvic pain syndrome", which used to be considered a form of prostatitis.  Start your reading with the excellen Wikipedia article.  As you will see, CPPS would also fit with my guess about a psychological cause of your symptoms.

Don't ask your provider for any particular exams or tests.  Just explain your symptoms and follow his or her advice after that.

[H. Hunter Handsfield, M.D.]

I only noticed the herpes question as I was sending my last comment. Herpes is not a rational explanation for any symptoms you describe.  I recommend against testing for it.

[reallyterrified]

Thank you for your patience and timely response Doc. I really do appreciate your advice and re-assurance. Once again..Thank you.