Very Worried

[alittlebitconcerned00]

About one week ago I had vaginal sex with a sex worker in Korea. She gave me brief oral sex but only on my testicles. Then after she gave me a handjob with lubricant. Then we tried having vaginal sex. I said tried because at that time i was a bit intoxicated and I wasn't able to get an erection. She put the condom on (that she provided) and I tried several times to insert my penis into her vagina. Seeing how it didn't work she put some lubricant on the condom and she inserted my penis by sitting on top of me. However that was very brief. Then finally after some more attempts we had a brief moment where I actually inserted my penis into her vagina. During this time I looked down and I saw that since I was somewhat flaccid, half of the condom slipped down my shaft although if I remember correctly the head of my penis was still covered. Then after some more failed attempts she took off the condom and finished me with a handjob (with lubricant). I then took a shower and went home. Two days later, I started to experience pain or uncomfortable soreness in my groin area. My right testicle is also a bit sore.  After a couple days I started to get worried and went to a clinic here in Korea. I took a urine test and the doctor told me after that I had some kind of inflammation and some bacteria was found. I started to freak out and I asked him if it was STDs but he said he wont know for sure until they take the sample to the lab which takes about 5 days. He then gave me a shot and medication to take to ease the discomfort. So my questions are:

1. What are the chances that I have STDs?
2. Should I also worry about HIV and get tested?
3. Do symptoms of STD's occur after only 2 days of exposure?
4. If it was something bacterial, can it be non STD related?
5. Lastly, even though I wore a condom, since I was flaccid and the condom did slip down about halfway, is it possible that some of her vaginal fluids might gotten into the condom and to my urethra (i am uncircumcised)

[alittlebitconcerned00]

Doctor,

I know you said your last post was your last response but I want to give you an update on my urine sample. The tests came in and the doctor told me that I have chlamydia. The doctor gave me four 250g of Zithromax.
I am shocked and confused because I used a condom that night. I'm worried now that the condom broke or the condom slipped off.
I just have a several more questions if you don't mind answering for me.

1. I read that symptoms of chlamydia usually occur 1-3 weeks after exposure. However I started to experience symptoms (groin pain/testicular pain/slight burning sensation) 2-3 days after my possible exposure. Can symptoms of chlamydia occur after 2-3 days?

(On a side note I've been in a monogamous relationship for a year and about a month before my CSW incident, me and my girlfriend had unprotected sex. However during our one year together I tested for all types of STDs twice in a span of 3-4 months and all tests came back negative.)

2. Because I've been diagnosed with chlamydia, should I get an HIV test in the future?

Thanks for your help doctor.

[Edward W Hook, MD]

These will be the last responses.

1.  If you took the antibiotics I mentioned, and it sounds as though you may have, they would provide effective therapy for nearly all bacterial STDs.

2.  Possibley

3.  Hard to say. You should discuss this with your own docotr. As I mentioned, it may not be an STD at all.  Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned.  This in turn leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  Perhaps this was a contributor to your situation.  EWH

[alittlebitconcerned00]

Oh I forgot to mention about the medication but the doctor informed me that they were anti-bacterial pills. I received three different pills. Although I cant read two of the pills, one for sure says azithromycin so as you stated from your previous post they are probably medications for common STDs.

1. If I finish taking the given amount of pills and the problem still isn't going away then I should definitely rule out STDs correct?
2. Also I have been masturbating a lot these past couple of months and I was wondering if that with the manipulation of my genital area that night can cause these soreness in my groin/testicles.
3. It has been exactly one week now and I haven't gotten any penile discharges or open sores. Just been having groin and testicle pain soreness. What kind of non-STD related infection do you think I could have gotten from my personal experience that night?

Thanks again doctor. Those are all the questions I can think of. You definitely gave me a sense of relief with your responses. I will find out what kind of infection or the cause of my symptoms next Monday so I'm hoping its not STD related or anything else serious. Have a good day and wish me luck!

[Edward W Hook, MD]

1. The white blood cells are suggestive of an infection but an STD remains unlikely since you had a condom on.  You should have found out what medications your doctor gave you.  You should be asking the docotor who treated you about next steps since he/she klnows what medications you received and what your tests show.

2.  You partner manipulated your penis and genitals both in the process of masturbating you and in trying to get you arroused (with only modest success from what you tell me)

3.  I don't knwo whare you are getting your information but this is not a debate. You asked for my opinion, I gave it to you.  The opinion is based on studies conducted on thousands of people.  EWH

[alittlebitconcerned00]

Thank you doctor for your reply. I am still experiencing groin and testicle soreness/pain (only on my right side). I called the clinic today and spoke to the doctor about my urine test and he informed me that white blood cells were detected in my urine indicating that I have some kind of infection. I am also experiencing a burning sensation when I urinate and the color of my urine is dark orange.After I finish urinating, the burning feeling doesnt go away for a while.

1. If I do have an infection and if that is the reason why I am having these symptoms can it be STD's or can it be a non-STD bacterial infection ?
2. Also I apologize but can you explain to me what you mean when you said that there was a fair amount of manipulation of my genital area? I know when I received handjob both times I was pretty flaccid.

The fact that the doctor told me that I have some kind of infection deeply worries me. I'm worried that it could be gonorrhea since I found out that symptoms occur as early as two days. However I haven't experienced any penile discharges.

3. My final question is that I have been hearing two conflicting reports about condom slippage during vaginal intercourse. I've heard that if the condom isn't covered up to the base of the penis you are not fully protected but I've also heard that as long as the head of the penis is covered you are protected. I know im at minimal risk from the oral sex on my scrotum, but I just have a feeling that trying to have vaginal sex while i wasn't fully erect (even with a condom) that I could have gotten  STDs, especially from a prostitute.

[Edward W Hook, MD]

Welcome to the Forum. from what you tell me, your risk for STDs from this exposure is quite low.  There is no risk for STD from receipt of masturbation or from your partner having oral contact with your scrotum.  For what vaginal penetration occurred, it sounds as though a condom was in place, covering the head of you penis and this makes this contact safe sex as well.  On the other hand, it sounds as though there was a fair amount of manipulation of your genital areas during your activities with this partner and these may be the cause of some of your symptoms.  

You were not clear what medication you received and that would be good to know if possible. Typically when a shot and pills are given these are ceftriaxone or Rocephin and either doxycycline or azithromycin which are therapy for the most common STDs (i.e. gonorrhea, chlamydia, NGU).

As for your specific questions:

1.  Very, very low for what you tell me.
2.No, the exposures you describe do not put you at risk for HIV either.
3.  2 days is on the early side for the onset of STD symptoms, particularly for groin pain and testicular pain which would be rather unusual as isolated STD symptoms.
4.  I doubt that it is an infection of any sort. Urinary tract infections are rare in men.
5.  No, as long as the condom was covering the head of your penis and it stay on, the fact that a portion of your penis was exposed does not increase your risk.  EWH