Help very worried

[Chris1234567]

Hello doctor
I am male heterosexual and live with a female partner. 2weeks ago I got very drunk and went back to a female work colleagues house where we both had unprotected oral for approximate 10-15 mins then protected vaginal only for about 20 seconds as I was very drunk. I thought nothing more of it until 2 days later when I started to feel that the top of my penis was moist and sticking to my underwear slightly. There was no burning during urination etc. I noticed that there was a minute clear discharge. I went to the local gum who swabbed and said I have non specific urethritis and will phone me next week with test results. I am panicking as I am gettin married next year to a girl. She gave me oral sex 2 days after the drunken encounter (no vaginal etc). Could I have passed chylamidea or gonnoreah on to her from her giving me oral sex? She has also just been prescribed a weeks worth of erythromycin at 250 4 times a day. Would this cure any potential infection for her had I passed one on? Also I have confronted the female I had the sexual encounter with and she stated that she was tested for all STD about 2 month ago which were negative and she has not had sexual relations with anyone since before me. This is my first encounter with another for 4 years and my girlfriend had a coil fitted a few months back and was tested then and all negative. Please advise on the likelihood of me passing something to my girlfriend and wether the anti biotic she is on would clear her if infected. I am very worried.

[Chris1234567]

Many thanks Dr.
Apologies if I have been a pain.
Chris.

[Edward W Hook, MD]

LAst answer.  Yes, this would be recommended therapy if you had mycoplasma or ureaplasma urethral infection.  This thread is now over.  EWH

[Chris1234567]

Hello Dr.
Thanks for the replys.
I was given a single dose of azithromycin at the sexual health clinic after originally being diagnosed with NSU on 29th December.
Would this have been effective on ureaplasma or mycoplasma?

[Edward W Hook, MD]

Evidence of ureaplasma or mycoplasma infection would have been apparent when specimens were looked at under the microscope.  If you were infected, the antibiotics you took are not the ones recommended (azithromycin is most often used) but may have had a beneficial effect.

You are worrying too much about this.  You need to get your anxiety under control and move on.  EWH

[Chris1234567]

Hello Dr,
One further question i have. I still seem to be getting the symptoms as described above.
Are Ureaplasma or Mycoplasma an issue i should be concerned about?
Would these not have been picked up at the sexual health clinic when the Dr's examined my swab under the microscope or in my urine test at the GP's?
The Dr at the sexual health clinic said there were no signs of infection or trich, herpes etc on my slide and that i was free to resume normal sexual activity.  
Would the anti biotics i have taken cleared these up aswell if i was infected with either?
Many thanks.

[Edward W Hook, MD]

You have been cleared of STDs through examination and testing not once but twice and, despite the absence of finings, you were treated (probably unnecessarily).  You can be confident that you do not have a persisting STD from the brief, low risk exposure you describe.  My sense is that you are worried an perhaps feeling a bit guilty.  In addition you are focused and examining yourself more closely than I suspect you were in the past.  A certain amount of moisture/secretions is normal at the urethra.  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.  I suspect that this is a contributor to your situation.  There is no reason to be worried further about STD from the exposure you described.  EWH

[Chris1234567]

Hello Dr. I would be grateful of your advice re my ongoing problem. I am going out of my mind with worry. As above on 17th Dec 2010 I had a drunken sexual encounter with a female friend ,who has informed me that she had a sore throat on the night in question .We had protected vaginal only for a minute or so and unprotected oral both ways. A day or so later I felt my penis was moist, at times catching my underwear and slight clear discharge inside the urethra. Went to sexual health clinic 29th Dec and confirmed I had a collection of White cells and nsu. I was given azithromycin to take which I did. Swabs were taken before medication and all stds came back as negative. I was still getting symptoms a few weeks later so went back to clinic. Dr took swab and examined my penis said no sign of infection or trich,herpes etc and said i was all clear of STDs and to resume normal sexual activity.The female I had the encounter with also got checked and was negative for all STD. I was still getting symptoms so went back again to the clinic a week later and was checked by another Dr. He swabbed and said no sign of infection. I left it for a week or so but was still feeling my urethra had clear liquid in it and when I looked inside I could see liquid,it is not a lot but it is there, the liquid can be gently massaged out and is sticky clear liquid like 'pre ***'. Also stickiness of penis head through day at times and on a morning. I went to GP who checked my urine which was normal and gave me 10 days of tremathoprim anti biotics. They have not cleared it. What could it be? I am very concerned. After getting the all clear from the clinic for STD i have resumed sex with my regular girlfriend and tried to forget about it but the problem is still there. Please help. Many Thanks

[Edward W Hook, MD]

Welcome to the Forum.  your only exposure of concern is your unprotected oral sex.  The condom protected vaginal exposure is safe sex and did not put you at risk for STD.  NSU following oral sex is almost never due to chlamydia and is thought to be due to the introduction of oral bacteria into the penile urethra where they cause irritation.  Since these are "normal" bacteria (at least for the mouth, there is thought to be little risk to partners from acquisition of such infection.  NSU following receipt of oral sex should be treated in the same fashion as NSU following vaginal sex, that is with either 1.0 grams of azithromycin as a single dose or with doxycycline, 100 mg twice daily for 7 days.  There is less emphasis placed on partner notification for NU following oral sex.

As for your GF, in addition to being low risk, 250 mg of erythromycin daily 7 days is a bit lower than the dose of erythromycin recommended for NSU (500 mg 4 times daily for the same 7 day period) but is likely to be adequate to reduce any further risk of infection.

Thus, there is probably little risk to your regular partner from her having performed oral sex on you and her treatment is likely but not proven to be effective if she was exposed to something (very unlikely as I explained above).  Sorry I can't be more definitive but there are just no good studies which define the best management for non-chlamydial NSU following oral sex.  Obviously, honesty is the best policy in such situations, as difficult as it may be.   EWH