Should I see a doctor? Abstain from sex? Inform parters?

[dumbanon]

10 days ago, I had sexual relations with a someone of unknown and likely high-risk STD status. She used her hands and breasts on my penis, there was no condom. There was no other contact -- oral, anal, or vaginal.

Almost exactly 24 hours later, I started coming down with the symptoms of a cold and a started having what felt like a UTI -- a frequent urge to pee (even when I didn't need to), and occasionally burning sensations when I did.

3 days afterwards, I went to see a doctor, who performed a dipstick test on my urine, which came back positive for blood in my urine. He prescribed an antibiotic for the UTI symptoms, and said it was intended to cover the sinus infection I seemed to be developing. He didn't perform any direct inspection other than the urine test.

The cold progressed normally, and primarily cleared up yesterday (about 10 days afterwards). I still feel a general sense of ill/malaise, but it's getting better. The UTI symptoms also seem to be mostly cleared up as of yesterday, with the antibiotic course nearly being completed.

However, I've noticed ongoing tingling/burning sensation on my penis and scrotum for the past few days, mostly centered in areas where my penis touches my scrotum while at rest, underneath the glans, and where the 'shaft' meets the sensitive skin below the glans (sorry, I don't know the name for that area). I don't see anything other than some occasional general redness/shininess.

I'd write this off as irritation, but in combination with everything else, I'd like to get a doctor's opinion on what the responsible next steps would be. Should I see a doctor for a physical evaluation? Should be concerned about any potential of exposure to immediate sexual partners?

[Edward W Hook, MD]

Thanks for the initial information.  These symptoms still do not suggst any STD in any way.  perhaps there is another dermatological problem going on.  You might want to have a dermatologist take a look,.  In doing so, I would have no concerns that this is an STD.  EWH

[dumbanon]

Hi Doctor,

None of the symptoms you've described have emerged, but the burning sensation that started a few days ago has continued. It seems to be related to that my genitals being moist or constrained, and is centered largely on my scrotum, glans, and tip of my penis, which tend to be the areas most likely to touch my underwear. Always feels better after a night's sleep, worse with more constricting clothes/heat. This probably doesn't sound like a STI at all, but it's driving me nuts.

Thanks for your additional insight!

[Edward W Hook, MD]

The major symptoms to be on the lookout woudl be a penile discharge, burning on urination or development of a rash or sores at sites of contact.  I doubt that these will occur but should they, you can post here in follow-up and I can provide limited follow-up.  EWH

[dumbanon]

Thanks for your response. The sensation burns or feels cold more than it itches or tingles.

I'll put the concern out of my head for now -- are there any symptoms I should be aware of that would warrant a doctor's visit?

[Edward W Hook, MD]

Welcome to our Forum.  I'll be glad to comment and have several thoughts which I hope you will find helpful:

First, even most high risk partners do not have STIs and most STIs are not transmitted from infected persons on a single exposure.

Second, this was a virtually no risk exposure for traditional STIs.  STIs are not transmitted by masturbation, whether the masturbation is performed using a partner's breasts or hands.  These infections are only transmitted through penetrative sexual contact.  Thus there is nothing about this contact that I would worry about.

Third, the onset of your UTI symptoms is inconsistent with any STI.  There are no STIs which produce symptoms within a day of contact.  Two days is the very earliest for this to occur and even that is far quicker than the norm.

Fourth, both UTIs and STIs are indicated by the presence of white blood cells in genital secretions and urine, not the more common red blood cells which, I believe is what you are referring to regarding your urine test.  

Fifth, and mostly as an FYI,  cephalexin has relatively little activity against most STIs.

Finally, the sensation of tingling and mild itching is a common experience when persons begin to scrutinize themselves looking for signs of an STI.  This most often is due to becoming aware of normal genital sensations, and not due to infection.

In summary, my suggestion is to not worry about this as a possible STI. There is little to be gained by testing.  

I hope my comments are helpful. EWH

[dumbanon]

Just one more comment, I was so wrapped up in describing my concerns, I forgot to thank you for your time and expertise! So, thank you.

[dumbanon]

Also, if it matters, the antibiotic is cephalexin.