unprotected oral

7 weeks ago I had unprotected oral sex from a prostitute when I was drunk. (She used a condom, but her saliva was in it .. she popped it out of her mouth onto my penis. I also then had protected vaginal sex with her.
The next day i took azithromycin 2 grams/ciprofloxacin 500 mg for 2 days/flagyl 2 grams/ and doxycycline 100 bid for 5 days.
Ten days after the exposure i had the onset of buring in my penis. There was no discharge, and no pain with urination.
There was some pain with ejaculation. Day 14 I got a urine analysis, Gonorhea/Chlaymydia test, and a CBC. All were normal. I started getting flank pain and abdominal pain. I never had any lesions/discharge/pus, etc .
I got a full std screen on day 20 (negative for HSV-1,2, syphyiliis/G/C/HIV)
I am now 7 weeks out. The flank pain is gone, the abdominal pain is rare, but my penis still burns, and ejaculation is painful. I never had any discharge/lesions/painful urination
1) What stds am I at risk for? Did I take the right antibiotics?
2) Could my flank pain/abdominal pain  be from side effects from the antibiotics?
3) Is there any std that causes flank pain/abdominal pain/penile burning?
4) I have been beside myself because I am married, and I am a healthcare professional, but I am not knowledgeable  about stds. I have jeopardized my marriage. I think the guilt is causing or worsening the symptoms.

Thanks for your help and understanding

[Edward W Hook, MD]

You are not at risk for STD and do not need any further testing.  Here are my comments:

1.  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.   If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection).  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 and you were condom protected.  Thus you really were at no risk for getting an STD from this exposure. I would urge you not to worry.

2.  The therapy you received would treat and/or prevent virtually all bacterial STDs, including things that you were not at all at risk (for instance there is really no need for metronidazole).

3.  Your STD tests prove that you do not have an STD and do not need further therapy.

4.  Symptoms of abdominal pain and penile burning ca occur due to STDs.  On the other hand, you don't have STD and do not need further therapy (these are facts).  These sorts of symptoms also are rather common sensations following an exposure which generate embarrassment and anxiety.  To be honest, I think the symptoms you describe are most likely due to your anxiety and concerns.  

Hope this helps.  EWH