NGU concerns Safe Sex practices

[Winter06]

I am a gay male 30YO.  I need some advice on NGU and safe sex practices.  Four days ago I had both oral and anal sex.  I received oral as well as rimming (unprotected).  It is important to note I received oral before rimming (and no time after rimming did I receive oral).  Additionally, I had anal sex as recipient (protected with condom that did not break).  There was also mutual masturbation. He did not *** inside me as that was done after sex (he masturbated after and came on himself). I have been on Levaquin 500mg/day for a week (sinus)and when this occured when I had been on it for four doses.

Symptoms:  I have the need to urinate frequently and a little discomfort after I pee (no real burning).  I wrote back in December that I am having what appears to be moisture in my urethra (has been going on for four months).  Previously you mentioned that I could have post-inflammatory issues (how long could that last for?).  That is how I usually have sex (above).  What are my chances for STDs?  High, low, etc. I do not let a guy *** inside me (even with a condom on). I have not seen any ulcers on me, signs of herpes, (nothing external to suggest warts).  Will levaquin cover Gonnorhea and Chlamydia or NGU?  How will I know if I get these?  Also, for four months my pre-*** has been higher in volume and much more watery.  Prostatitis I can not get rid of?

Thanks

[H. Hunter Handsfield, M.D.]

I would rate your STD risk from the encounter you describe as very low, close to zero.  I doubt there is anything wrong at all.  Any thought of prostatitis is speculation.  In any case, only evaluation by a personal provider can be certain whether anything is wrong.  The only realistic source of urethral infection would be your partner's mouth--and although that is possible, Levaquin should prevent any such infection and is also active against chlamydia.  It is also active against most strains of gonorrhea, but not all--but if you had gonorrhea, you would have an overt, yellow-ish, pus-like discharge from the penis.  No STD is known to affect the appearance or amount of pre-ejaculate fluid.

Sorry I can't be of greater help.  Best wishes--

HHH, MD

[Winter06]

Dr.  Thanks again for your input.  How concerned should I be about Herpes with this contact?  I noticed last night a small scab on the top of my penis. Probably from rough masturbation.  I had to scratch pretty hard to get it to come off.  It bled a little and now it is fairly sore.  Could this be simply normal pain from "over use".  How would I know if it was herpes?

Thanks again.

[H. Hunter Handsfield, M.D.]

Herpes is possible with the exposures you describe, but very low risk.  New herpes (only a few days old) would not start with a single scab, but I suppose it is possible you have had it a long time.  But I cannot diagnose or accurately judge based on your description.  How would you know?  See a health care provider for proper diagnosis.  In the mean time, read up on herpes to learn the usual symptoms and signs; it is much too complicated for me to briefly describe here.

HHH, MD