Did I invalidate my results?

[Scott C]

I'm a 30 year old heterosexual male. I don't use drugs, drink alcohol, or smoke. I had a sexual mishap four years ago (condom failed). I developed symptoms of a UTI (white discharge, visible bacteria in toilet after peeing). I was too embarrassed to go to a doctor. I just recently got the nerve to have lab work done which included testing for Chlamydia, Gonorrhea, HBV, HCV, HIV, HSV I & II, and Syphilis. All negative. I was sexually abstinent during the four years I put off getting tested.

1) Since Chlamydia and Gonorrhea were negative, would you assume Trich.? Testing didn't include Trich.

After the lab work, however, I had a moral relapse. I had sex with a female escort while out of town on a business trip. Sexual activities consisted of protected vaginal intercourse and protected fellatio, but deep French kissing and unprotected cunnilingus. I feel like an idiot. I was abstinent for four years and then do something stupid like this. What makes things worse is that I just go tested.

2) Does this relapse invalidate my lab results? The San Francisco City Clinic website says kissing and cunnilingus are considered safe sex. Do you recommend I get retested or take antibiotics as a precautionary measure?

[H. Hunter Handsfield, M.D.]

First, no bacterial STD lasts 4 years in men. That includes trichomonas.  Second, a discharge from the penis means urethritis, such as nongonococcal urethritis (NGU), chlamydia, gonorrhea, etc.  A UTI does not cause discharge, and UTIs are rare in healthy younger men.  Third, you cannot see bacteria in the toilet after peeing, assuming you didn't scoop up the toilet water and look with a microscope.  Fourth, you can make your own definitions of your own behavior, but you don't describe anything that sounds to me like a "moral lapse".  A single guy, not cheating on a partner, having protected sex with an escort sound like pretty normal behavior by most standards.  Fifth, you had condom-protected sex with the escort, so could not have acquired an STD.  The risks from oral sex are too low to worry much about.  Sixth, the answer is yes:  if despite your negative tests and all the other certainties against STD you somehow had a bacterial STD, the combination of ceftriaxone (Rocephin), doxyccycline and sulfa-trimethoprim (Bactrim) would have cleared up any possible infection.

You don't say what symptoms you still have.  But whatever they are, they cannot be due to an STD acquired either 4 years ago or your more recent adventure with the escort.  Of course if you are convinced you have abnormal symptoms, you need to get over your irrational embarrassment and see a health care provider.  Stop trying to self-diagnose or to get definitive information online.  It isn't going to happen.

Best wishes--  HHH, MD  

[Scott C]

I'm still having UTI symptoms from the initial mishap. Symptoms didn't go away with the Rocephin or Doxycycline. I didn't no if I made this clear in the original post. I promise no more additions to the original post.

[Scott C]

I think I should've said "false negative results" instead of "false positive results." You'll have to excuse my ignorance in regard to medical terminology.

[Scott C]

I forgot to mention that I was treated for a staph infection during the four years I put off getting tested (Rocephin shot and two week regimen of Doxycycline and Bactrim DS). The antibiotics were taken two years before I had my lab work. So the negative Chlamydia and Gonorrhea results should be definitive. In other words, there shouldn’t be any false positive results regarding Chlamydia and Gonorrhea.