Concerns of STD

[hobart1]

Doctor
About 2 months ago I had brief unprotected oral with a girl who came to my hotel room to give me a massage.  She also rubbed herself on me, her vagina may have touched my penis but there was no penetration.  About 2 weeks ago I noticed that my scrotum was red but thought nothing of it.  Today, my right testicle is slightly swollen, not painful or tender.  I think I might have tender lymph nodes in my groin.  I had a vesectomy in May last year.  My question is, could the oral or other physical contact given me an std that has casued epidymitis?  My testicles are not sore, its just that the right one now looks bigger than the left, my scrotum is a bit red (at times, this seems to come and go).  I have had no discharge, no burning, although urination over the last couple of days has been more frequent (and I recall that this happened a couple of weeks ago, over the weekend).    I understand that oral sex is an inefficient mechansim to transmit stds but something is definately going on here.  Appreciate the help.

[Edward W Hook, MD]

Following a vasectomy it would be most unusual to develop epididymitis; the surgery would prevent passage of bacterial to the testicles. If you acquired urethritis (penile infection) from receipt of oral sex, most often you would have symptoms such as discharge or burning an urination and they would have been evident well before two weeks had passed.   Furthermore scrotal swelling without pain is really not suggestive of epididymitis and is more consistent with some other sort of problem, possibly related to your vasectomy (you did not state when your vasectomy was).  

I suspect that your swelling is unrelated to the encounter you describe.  I would however  get it evaluated by  a trained health care provider.  The evaluation should include laboratory tests for signs of inflammation in your urine or a swab specimen form your penis and should be obtained before any treatment is administered. These tests will be more reliable if it has been at least an hour, and preferably two between the last time you have urinated and the time the specimen is collected.

Hope this helps.  EWH

[Edward W Hook, MD]

Your doctor will decide which tests should be performed.  I would probably test for gonorrhea, chlamydia, white blood cells and do a culture for bacteria but cannot be sure because examining you would help me to decide what tests to do.  You doctor may decide to do more or less, based on his/her examination.  EWH

[hobart1]

Doctor
thanks for your advice, I have arranged to see a doctor tomorrow.  What specifically needs to be tested for in my urine.  My vasectomy was in late May 2008.