Epididymitis symptoms / STI risk after massage

[jimmy042012]

Hi Drs,

5 weeks ago I visited a place and received a 30min body to body massage ending with a handjob. During this time the lady rubbed herself all over my body, including her pubic area and rubbed my meatus having massaged around my bottom, close to my anus. As far as I could tell, there was no direct oral or vaginal contact.

A few days after, I started getting a tingling/burning sensation after urinating but no discharge. My wife mentioned some pain in her ovaries after we had masturbated.

After 10 days, I visited a sex health clinic and took a urine test for Gon/Chla. This came back negative.  I don't believe I've had any discharge since the visit. However the unusual sensations after urination continued and I started getting some pain in my left teste and generally feeling unwell (hot, headache, beginnings of a sore throat, one night of sweats).

5 weeks have passed and I have since seen a Dr whilst on holiday (who I didn't tell about my STI test or visit to massage place) who has prescribed Trimethoprim for Epididymitis. After 3 days of the antibiotics, the testicle is still painful although it feels better first thing in the morning.

Questions:

1. Could I have picked up any STIs in the encounter even if the risk is supposed to be very low.
2. Can I rely on the test I took? (Could I have a false negative for the urine test I took?)
3. My wife and I have only mutually masturbated a couple of times since the event . If I have Chlamydia could I have passed it on this way?
4. I have some itching, normally a minute or 2 after passing urine. Is this itching typical of Chlamydia itching or would that be more constant (like a jock itch)?
5. I have read about CPPS. I can understand I could have CPPS but could I have CPPS AND epididymitis from an infection?
6. Could I get another urine test for G/C whilst on Trimethoprim? What options might I have regarding retesting?

Thanks for your advice.

[Edward W Hook, MD]

Welcome to the Forum.  I see that you asked some of the same questions about two weeks ago.  My answer will not be too different. the sort of contact that you describe is not associated with any meaningful risk for STD of any sort.  On the other hand, the mind is a powerful thing and increased focus on one's genitals, as well as anxiety, can combine to make people notice sensations that normally go unnoticed.  This may well be a contributing factor to your situation.

You don’t mention whether the doctor you say examined you or not.  I hope so. Typically, when treating epididymitis, it is recommended that a repeat examination be performed a few days after initiation of therapy to document improvement.

As far as your specific questions are concerned:
1. Could I have picked up any STIs in the encounter even if the risk is supposed to be very low.
See above.  This was a no risk event for STIs.

2. Can I rely on the test I took? (Could I have a false negative for the urine test I took?)
Currently available tests are among the most accurate tests we have ever had and are almost never falsely negative.  I urge you to believe your test results.

3. My wife and I have only mutually masturbated a couple of times since the event . If I have Chlamydia could I have passed it on this way?
You do not have chlamydia (i.e. believe your tests) and even if you did, you could not pass it on through mutual masturbation.  Penetrative sexual contact is required for transmission of chlamydial infection.

4. I have some itching, normally a minute or 2 after passing urine. Is this itching typical of Chlamydia itching or would that be more constant (like a jock itch)?
No this is no way suggestive of chlamydial infection.  It odes suggest however that you are overly focused on your search for symptoms and, as a result, are detected normal sensations.

5. I have read about CPPS. I can understand I could have CPPS but could I have CPPS AND epididymitis from an infection?
Most unlikely.

6. Could I get another urine test for G/C whilst on Trimethoprim? What options might I have regarding retesting?
There is no medical need for re-testing.  Retesting while on antibiotics is not useful.  I would suggest waiting until you have finished your antibiotics for at least a week.

EWH

[jimmy042012]

Thanks for the follow up Dr. I'll leave the rest of my questions for my GP/Specialist.

[Edward W Hook, MD]

No, these sorts of symptoms are not associated with Mycoplasma genitalium.  EWH

[jimmy042012]

I should also mention there is definitely itching at the end of my penis. I cannot be imagining this.

[jimmy042012]

Hi Dr Hook, I now have my appointment with my GP. My testicular ache has been better over the past couple of days but the inflamation of my meatus remains (since my encounter).

The lady rubbed my meatus with the thumb or fingers (not just brushed) and I was wondering if this could have introducted other bacteria (Mycoplasma genitalium etc) and is worth discussing with my GP?

Apologies for coming back with another question.

[Edward W Hook, MD]

Yes, this sort of non-specific testicular pain can be a manifestation of stress. the only proper way to be sure however is with a direct physical examination.  You were not served well by a physician who did not examine you.  EWH

[jimmy042012]

Thanks for your response Doctor. There was no examination by the Dr and I am seeking a follow up with my own GP this week.

One last question if I may.  I wasn't sure why my testicle had started aching 5 weeks after the event and began to wonder if the cause was the spread of an infection (and reason for ongoing general pain). Could pelvic tension / CPPS (from my stress) actually cause this much more distinct testicular pain (ie. there is neither STI or UTI?).