STI?

[Tex812]

A week ago Saturday I had a one-off sexual encounter with a woman. I wore a condom during the ENTIRE encounter. There was no penetrative intercourse and no contact between our genitals. She stimulated me orally and manually, during both of which I was wearing a condom correctly. The manual stimulation was pretty rough and lasted a long time, as I was unable to get a full erection.

The next day, I started to experience irritation in my urethra and a slight burning feeling while urinating. I had no discharge and had not noticed any other symptoms at that time.

I visited the local clinic on Wednesday. I didn't go into any details with the doctor - I just told him my symptoms and that I had had a sexual encounter. He prescribed "one shot" doses of three medicines in tablet form - Azithromycin for chlamydia, Metronidazole for trichomoniasis / gardnerella and Levaquin for chlamydia / gonorrhea. The doctor decided not to give me any tests for STI's.

I took the Azithromycin on Wednesday afternoon, the Metronidazole on Wednesday evening and the Levaquin on Thursday afternoon. My symptoms are about the same as they were last week, plus the area surrounding the opening of my urethra now looks slightly discolored - darker purple than the surrounding area.

Questions: Given the detailed description of my encounter and my symptoms, what is the likelihood that I contracted an STI? What is the likelihood that I contracted some other infection in my urethra? What is the likelihood that the rough and long hand job simply bruised or irritated my penis and urethra? If I did get an STI, how long after taking the listed medications should my symptoms subside? How long would I remain infectious after taking the listed medications?

Thanks for your help.

[H. Hunter Handsfield, M.D.]

Your follow up comment below has it right.  No STD can cause symptoms the next day, and in any case you were fully protected, at least from any infection that could cause urethritis or the urethral symptoms you describe.  Some sort of physical or chemical irritation is the only possible explanation, e.g. from lubricant, especially if a spermicide was involved.  The lack of discharge also argues against urethritis; discomfort alone is not the usual picture.

It's too bad your local clinic jumped the gun.  MedHelp moderators are asked to not overtly criticize patients' health care providers.  However, I cannot avoid saying that it was wrong for you to be treated for STDs without even examining or testing you.  There is no excuse for that sort of behavior by medical professionals - and I don't mind if you print this out and take it to the clown who treated you.  The fact that your symptoms haven't responded to the antibiotics is further evidence that no infection was involved.

To the specific questions:

Likelihood you acquried an STD that explains your symptoms?  Zero.

Some other urethral infection?  Zero.

Physcial bruising/irritation?  Good bet.

Time for symptoms to resolve if due to infection?  Irrelevant in your case.  Hypothetically, definite improvement within 1-2 days and complete resolution in a week to 10 days.

Duration of infectiousness for another partner?  Irrelevant in your case.  Hypothetically, no more than 1-2 days, regardless of symptoms.

I hope this helps.  Best wishes--  HHH, MD

[Tex812]

Thanks a ton, doc. I tended towards physical bruising, but have been freaking out because I don't want to ruin things with my wonderful girlfriend.

I also appreciate the fact that you answered my hypotheticals. It seems that, even in the extremely unlikely chance that I was infected, the treatments would have made me untcontagious by the time I had sex with my girlfriend again.

Thanks for your time, and for providing a place where people like me can ask questions in detail, without the discomfort that comes from doing it in person, at the doctor's office.

Happy New Year!

[H. Hunter Handsfield, M.D.]

See my reply above.

[Tex812]

Follow-up:
After reading some more questions in the forum, my guess is that you're going to tell me I did not contract an STI last Saturday. For some extra information, we used 2 condoms, and there is a chance that I came into contact with vaginal secretions (from my hand or hers) between removing the first condom and putting on the second one.

Also, as a hypothetical, assuming that I contracted gonorrhea or chlamydia on Saturday a week ago and took the medications as I described above, what is the likelihood that I would have still been contagious 2 nights after taking the Levaquin / 3 nights after taking the other 2 medications?