brief unprotexted oral

[hopara]

Hello.

I am a hetero - sexual male. I tested negative for all stds about 1 year ago. I have been in a monogomous relationship with 1 girl for several years, who I know is also STD negative.

about 2 1/2 weeks ago, I had a very brief unprotexted oral experiecne with a high risk female (prostitue). My penis was in her mouth approximately 4 or 5 times for a total of a 30 - 60 second time period. I then masturbated to ejaculation after that. About 36 hrs before the experience, i had used an electric shaver to trim my pubic area. I had cut myself on my penis (a small cut) which looked pretty healed the next morning (prior to the incident). Although I know the skin on teh penis is very thin and coudl take weeks to fully heal.

About 1 - 1.5 weeks after the incident, I started noticing an itching sensation in my urethra. It came and went for a few days. Not really burning or pain, but just an itchy feeling. It felt good when I urinated to relieve the itch. Accompanying that symptom was a general feeling of having to urinate very often, and when I did urinate, it alwasy feels like I am not done, although no further urine comes out. The itching sensation is now gone, although I still feel like I am never fully relieved after urination. I did have what felt like swollen testacles for a few days right after the itchiness began, but that has since subsided. I have gone to my doctor ( about 1.75 weeks after incident and few days after itchiness began) and gotten tested for UTI, gonorreah, and chlamidyia. I am awaiting results.

Also, I have regularly examined my penis since the incident for herpes sores, and have not seen anything unusual. I

My questions are:
1. What are the chances of contracting ghonorrea from the experience I describe? I knwo chlamdyia is very low, but I have seen as much literature on gonorrea.

2. After my bacterial STD test resaults come back (it was a urine test), do you believe I need any other testing?

I am a nervous wreck. Thanks.

[hopara]

thanks.

[Edward W Hook, MD]

I have little more to say.  Your chances of having an STD were low to start with and you have had negative tests.  Indeed UTIs are rare in men but they do occur.  Having committed to care with a doctor you should work with him to get through this.  The three day therapy with levofloxacin is therapy for a urinary tract infection, not an STD.  Other possible causes could be prostate problems (which do occur in younger men) or a renal stone.  I am sure your doctor is thinking of these possibilities or has already ruled them out.  On occasion these sorts of problems do require trial an error to be fully addressed.

Your problems may be being amplified by your anxiety over this matter.  The mind has great capacity to do this.  My advice is to work with your doctor to address this.  At the same time,

Hope this helps.  work through this with your doctor. There is virtually no chance that this is an STD. EWH

[hopara]

doctor I noticed you replied to several other threads today, but not mine. Please advise.

[hopara]

i forgot one queston

4. if this is in fact a UTI and not an STD, can my partner get infected if we engage in unprotected sex?

[hopara]

Doctor;

I am a nervous wreck. The last weekor 10 days I have had moderate/severe pain in my testacles. This is about two weeks after I tested negative for ghonorea/clamydia with a urine test, and about a month after my brief unprotected oral sex encounter. The complicating factor is that about 2 or 3 days before teh testacle pain started, i had another sexual experience, but what i would consider a very safe one. A female gave me a handjob, but with her spit.

Currently, no burning or pain during urination. At times I think I have a little burning, but it is nothing significant. I was hoping the the testacle pain (which is one side) would subside, thinking it was again due to anxiety.

Today, after many days of the testacle pain not going away, I went to the doc again. He did a urine test on the spot and said there was a little blood in my urine, along with white blood cells. When he did this during my initial visit there was none (the visit where they ordered teh gon/clamydia test). He said it is likely some kind of infection/UTI. However, I have read on this forum that UTI's are very very unlikely for "healthy" men in their 20s.  He gave me 3 250-mg levaquins to be taken 1 each day for 3 days.

1. Is there any chance of this being an STD?

2. What can cause white blood cells and bloor in the urine? Can a viral infection cause this?

3. After my brief oral unprotected experience from a month ago, I tested negative for gonorea and clamydia. You instructed taht urine test was 100% conclusive and no other testing was needed. Then I had this experience with the handjob and spit as lubrication. I have read on other posts that is zero risk. If so, and if UTI is so unlikely, what is the explanation for this? He also tested for hernia and did a thorough physical examination.

Please help.

[Edward W Hook, MD]

The information you have received is incorrect.  AT the present time the recommended test of choice for gonorrhea testing is a urine test.  You do not need another test.

Your own doctor is being conservative and not taking any chances.  For people who don't deal with this type of medicine on an everyday basis, it is better to be safe than sorry and I will not and cannot take your doctor to task for being conservative.  At the same time, as you know, the risk of HIV varies with the type of exposure.  In your case, following a single receptive oral exposure, you really have nothing to worry about and have no need to abstain.  EWH

[hopara]

Got my rest results today. As you had expected, all negative/normal. Two follow up questions:

1. The gono/chlamdyia test was a urine test. I have read a lot of literature about cultures and swabs of the discharge and how that is the normal/gold standard test. Is the reliability of the urine test good and do I need to have another test if it is not?

2. My primary care doc (who is obviously not an infectious disease specailist like yourself) keeps insiting that I 100% need to get follow up blood work for herpes/HIV etc in 4 or 5 weeks (which would be 6 or 7 weeks post potential exposure).  That is somewhat contrary to what you have indicated to me that you suggest no further testing. Can you shed some more light here? I obviously have a monogomous relationship with a woman. Am I supposed to not have sex for 6 more weeks?!?! How would I explain that?

[Edward W Hook, MD]

I'll look forward to hearing your test results.  I'm betting they will be negative.  EWH

[hopara]

doctor very helpful thank you. When I get the results of my urine test, I will let you know what the results are. I definitely have an issue with urinating, but perhaps it is tied to a prostate issue. If my tests are negative, I will go to my doctor and further pursue this if my "symptoms" persist after what I hope will be a negative test.

[Edward W Hook, MD]

Welcome to the Forum. I doubt that you have anything to worry about.  Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned.  This in turns leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  Perhaps this was a contributor to your situation.  I suspect it is also the basis for the "leakign" sensation you have follwoing urination

You are correct that gonorrhea can be transmitted to another person through receipt of oral sex but it is not very common and when it occurs, the infected person tends to have visible discharge from the penis.  Your lack of a discharge makes this quite unlikely.

If your urine test shows white blood cells, while it may be interpreted as a urinary tract infection, it could also be non-chlamydial NGU from the introduction of mouth organisms into your urethra at the time of oral sex.  If this is the case it is easily treated.

In my opinion, you have little to worry about.  I presume the when your tests are available in a day or two this will be confirmed.  Once they are back I would not suggest any further testing.  Hope this comment is helpful.  EWH

[hopara]

i forgot to mention that although I have not noticed any blatant white/green/yellowish discharge, I do get the sense that my urethra is leaking a bit of fluid, which is tied to the sensation of never feeling fully relieved after I urinate. For example, sometimes after I urinate a few minuets later some liquid/discharge does come out of my urehtra. Thsi happens even more after I masturbate.