Scaredoverseas

[scaredineurope]

Dr.,

I have been between Germany and the Netherlands on business for the past 3 months and I'm leaving in 2 days to go back to the U.S. to my wife.  A few days ago I did something incredibly stupid.  I visited a sex worker in her house - she lives in Germany and is from Slovakia.  

A few days prior to this I was masturbating vigorously (not very lubricated) and had chaffing behind and on the head of my penis (I have a lot of foreskin and underneath I could feel the soreness and see skin peeling off).

When I visited the sex worker I engaged in protected oral sex, she kissed my neck/body and I rubbed her vagina - nothing more.  After I came there appeared to be zero damage to the condom and she carefully removed it.  When I got back to my hotel and showered I discovered the chaffing was much worse than before - to the point the head of my penis was swollen and in a few spot the areas with previously peeling skin were bleeding.

In scanning this site it is stated time and again - almost zero, if not zero STD risk from protected oral sex and an indication of an STD will not appear in mere hours.  My questions:

1)  I had protected oral sex, she never touched my penis with her mouth except when the condom was on - with the bleeding after she removed the condom in the previously chaffed areas has my risk significantly gone up?

2)  Is there a risk?  If so, what?

I'm due to see my wife in a few days and outside of the emotional side I personally have to deal with I'm scared to death to sleep with her.  Looking for advice on my risk in this situation.

v/r,

Scaredoverseas

    

[H. Hunter Handsfield, M.D.]

Stop trying to post questions in existing threads.  You have to use the Post a Question link.

[scaredineurope]

Dr.,

Thanks for the fast reply - I would like to mention that I am circumcised - but - as mentioned above I have a large amount of extra skin below the head of my penis (maybe foreskin was the wrong term to use).  I know you mention open lesions above - the initial chaffing was after a very specific session of masterbation - it was very dry.  

I will continue to clean as well as find the medication you recommend.  The combo of the soreness/chaffing prior combined with the bleeding afterwards has had me very worried about possible exposure to something (even with the condom use).

Again - thank you,


Scaredoverseas

[H. Hunter Handsfield, M.D.]

From your description, I wonder whether you have a fungal (yeast) balanitis, which can cause inflammation of the head of the penis, especially in uncircumcized men.  Chafing alone, whether from vigorous masturbation or something else, is unlikely to be the only explanation, although the masturbation might have made an impending problem more prominent.  Whatever it is, you can be sure you didn't catch it from your commercial partner, given the condom use; and with condom coverage, you were protected against any possibility that the penile inflammation increased your risk of acquiring HIV or other STD.

This is only a guess, and for a definite diagnosis, you should see a health care provider. If that isn't practical, I suggest retracting the foreskin and cleaning well with soap and water for a couple of days, and might also try an over the counter yeast cream. You might have to find something intended for women with vaginal yeast infection, or ask the pharmacist.  Anything whose generic name ends in "azole" (miconazole, clotrimazole, butaconazole, etc) would work.  If I'm wrong about yeast, it won't help--but it probably won't hurt.

For completeness, I should mention that herpes is always a consideration in otherwise unexplained inflammation associated with open lesions, suggested by the bleeding--but your description doesn't sound at all like herpes.

Finally, if you have a yeast infection, you probably should avoid sex with your wife until it clears up.  Although not considered an STD, she might get a vaginal yeast infection from you.  It's pretty common in uncircumsized men, so there is no need to mention your daliance in Europe.

Good luck--  HHH, MD