need help

[chetlee]

I am a 42 yr old male who had unprotected oral sex with for about 45 seconds to 1:00 and then protected vaginal sex for another minute or two I did not ejaculate. About 5 or 6 days later I began to experience urgency with very slight burning/itching not terrible but definitely there. About 5 days later urgency seemed to subside some but painful urination got stronger and my meatus was red and raised after urination as well as slight clear discharge this lasted a few days.
I think these have subsided due to the fact that a few days before I noticed irratated meatus I ws put on flagyl for a seperate condition. Since about 3 to 4 days into flagyl I have noticed almost all symptoms have gone. I am a married man who was unfaithful this once (I am sure you hear this all the time, but true), I had sex with my wife about 4 days after encounter and about a day before any symptoms there was unprotected vaginal sex without ejaculation for a few minutes and then I put a condom and finished protected in same session.

I am at my wit's end I love my wife dearly and have been sick thinking about what I have done. So here are my questions:

1) what is the likelyhood given the description above that it is ghonnerea or chlamydia or NGU?
2) Would the flagyl cure NGU or Ghonnerea or one or the other? I am hoping it takes care of NGU as this is easier to deal with for anything I would have to tell my wife. If it cures one or the other when would symptoms return?
3) Is it possible the intercourse I had with my wife above did not infect her?


Please help I do not want to lose my wife!

Thanks in advance!!!!

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  There is no risk from condom protected vaginal sex so we'll focus on the oral exposure.

Oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  In your case, your exposure was brief so your risk is a bit smaller.

That said, your symptoms are suggestive of NGU.  Flagyl (metronidazole) cures a small proportion of NGU but not most.  The recommended therapy for NGU is either doxycycline 100 mg twice daily for 7 days or a singe 1.0 gram dose of azithromycin.  With this as background, let's work through your questions:

1.  Se above. Chlamydia is not spread by oral sex and gonorrhea is rare.  I would be on non-chlamydial NGU, likely due to introduction of oral bacteria to your urethra during receipt of oral sex.  
2.  See above.
3.  It is not clear if non-chlamydia NGU is readily transmitted to others or what to do with partners exposed to non-chlamydial NGU.  Most single exposures on uninfected partners to partners with STDs do not lead to transmission of infection.  Nonetheless, if a visit to your doctor or a local STD Clinic reveals NGHU, by far the safest thing would be for your wife to be treated as a result of her exposure to you when you had  NGU.

I hope this helps. EWH

[Edward W Hook, MD]

This appears to be going on and on with my answers just fueling your anxiety. This will be the final answer.  Further answers will be deleted without comment.  This is most likey a coincidental, seperate event.  EWH

[chetlee]

Would it be common in a gonnerhea diagnosis or is this most likely a separate event?

[Edward W Hook, MD]

No. EWH

[chetlee]

Dr Hook I tested today and am awaitng my results in the meantime I believe I am coming down with conjuctivitis is this common in ngu?

[chetlee]

Thank you Dr Hook, I fully understand

[Edward W Hook, MD]

Prosatitis is a different condition which can mimic NGU in symptoms. The same is true for urinary tract infections which are rare in men but do occur.  It is difficult for me to endorse your plans to be un-truthful to your wife.  I'm sure you understand.  EWH

[chetlee]

I was asking because I read somewhere that there were nonsexual causes to ngu such as prostatitis and narrowing of urethra etc. I was hoping that there was some cover story I could have with my wife. As I mentioned in my first post I want to keep her healthy and my marriage in tact at the same time.

Having said all that thank you for your time and knowledge

[Edward W Hook, MD]

There are just no data to answer this question.  EWH

[chetlee]

I guess my second question is are there any possible non sexual transmissions of ngu, could the bacteria that causes ngu be common in my wife and not due to a different partner?

[Edward W Hook, MD]

1.  A test for NGU will still be reliable, even though you have taken flagyl.

2.  Not sure what you mean by this question.  NGU in the absence of sexual contact is extraordinarily uncommon. EWH

[chetlee]

Hi Dr Hook,

Thank you so much for your prompt response. I have few more questions for you. 1) Will I get a proper test result if I have been on the flagyl?

2) Is it reasonable that NGU can be transmitted non sexually? If so what are those reasons