How much trouble am I in?

[Dummy#1]

Well, here goes.  Like many others who have posted on this forum, I am dealing with a night of stupidity.  Naked lap dance at a strip club (we both were naked, no penetration), and she perormed oral sex on me to completion.   I have seen my GP and have been tested twice- once at 60 days for Chlamydia and Gonnorrhea, and a full panel at 4 months including HIV, HSV1 and HSV2, HEP A, B, C and Syphilis.  All were negative, but I have questions related to the reliability of the tests, particularly the Chlamydia and Gon.  

I still have some Penis discomfort, particularly during urination when slightly dehydrated after a long period of exercise. I am wondering if this could be related to an STD that was not tested for or if I have another issue that needs attention.

As far as the tests go, they ask for at least 2 hours without urination for accurate results.  How critical is the time duration to an accurate test?  In one instance it was 1 1/2 hours and in another it was slightly under 2 hours.

Also, are Chlamydia and Gon permanent infections, or do they go away with time?  If so, how long?

Thanks Doc!

[H. Hunter Handsfield, M.D.]

You can be "concerned" if you wish, but facts are facts.  What do you think happened to gonorrhea or chlamydia acquired in the pre-antibiotic era, that it lasted the life of the infected person?  Did everyone die of bacterial pneumonia or have chronic lifelong infection?  No, 90% survived an illness that typically was pretty unpleasant and lasted a few weeks; penicillin was lifesaving for most of the remainder.  The common cold goes away.  Boils clear up.  90% of tuberculosis self-cures.  Why should STDs be any different?

In other words, the large majority of human infections clear up on their own, given enough time.  The amount of time required varies widely, and some infections last forever (herpes, HIV) and others are uniformly fatal (rabies, untreated HIV)--but these are the exceptions, not the rule.

HHH, MD

[H. Hunter Handsfield, M.D.]

Oh, I just made it up.  I really don't know much about this business.  But I did stay at a Holiday Inn Express last night.

Or Google me.  Or go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi and enter "handsfield hh [au]" into the search window.  Then come on back if you would like to continue discussing my expertise.

HHH, MD

[questmed]

I am concerned about the idea that these bacterial infections clear up on their own. The last time I checked, you MUST take antibiotics for them to resolve.

[questmed]

Ok I am very concerned about this post and am SURE you must take antiobiotics to clear a bacterial infection like that. Where are you getting your information from, DR. HHH?

[questmed]

Trust me, I am not doubting your expertise. I think a discourse is more productive than outright blind trust OR outright disapproval of an opinion. Agree? Further, I had already looked up your credentials but thank you for providing the link otherwise. Why is it that in men, these infections clear up but with women, they are often extremely problematic.

[Imdumb]

You are in no trouble.  Your activity was very safe to begin with.  No change of chlamydia from unprotected oral.  Some chance of gonorrhea, but you would have had a lot of discharge and painful urination a few days right after.  

On top of that, testing for chlamydia and gonorrea would be 100% reliable just a few days after the encounter.

I think you pain is probably because you are thinking about it more.  

After 4 months you can be 100% sure all the tests you took are accurate.  

Low risk exposure, no symptoms and negative tests at 4 months = HOME FREE!

I have had a simliar experience.  I wasted a lot of time and energy on nothing.

[H. Hunter Handsfield, M.D.]

Wow!  That's a lot of testing for an extremely low risk exposure, a significant waste of time, energy and money. STD transmission to the penis by oral sex is uncommon to rare to nonexistant.  It has never been documented for HIV, HSV-2, hepatitis (any type), or chlamydia, so you definitely didn't need testing for any of those.  It is rare for syphilis and uncommon for gonorrhea and HSV-1 (and you likely would have developed symptoms if you caught one of those).

With the low risk of the event and the negative tests (twice), there is no chance you have gonorrhea or chlamydia as a result of that exposure.  Time since urination makes no difference; the 2 hr recommendation is common, but there are no good data on it and almost everyone would be positive on every test even if thye urinated every 5 minutes.

In men, gonorrhea clears up on its own after an average of 6 weeks, probably always within 3-4 months.  For chlamydia it is longer, but probably generally resolves within 6 months.

Good luck--  HHH, MD