Worried for possible std

[1985male]

Dear doctor,

I'd several things that i'm ashamed about. Here is my story

April 26: protected oral and vaginal sex. Removed the condom and masturbated untill ejaculation. This was with an escort. Possible vaginal fluids from condom on urethra when i took the condom of. I didn't think that the condom was broken.
April 28: unprotected vaginal with my wife. I did not ejaculate inside her.
1 week later i had a stinging feeling in my penis and in freaked out. Kept checking my penis for symptoms but didn't see discharge.
Me and my wife didn't had sex and i took 1g of zithromax. I waited for a week and we had vaginal sex unprotected. 2 days later i noticed slight clear discharge but i was aroused that day. I freaked out again kept squeezing and checking my penis.
July: my wide took amoxcillin 1000 g 2 x times a day for a throat infection. She did this for 8 days. And i took 1g zithromax the same time and we didn't had sex for a week.
Oktober: my wife was treated with azithromycine sandoz 1g and 500 mg the next day because she had her wisdom teeth removed. i took doxycycline 100 mg a day for 5 days and also 1,5 g zithromax on day 6. My wufe and i had sex after 7 days that i took the doxy and she the azithromycine.
Questions.
1) i was scared for ngu and chlamydia due to the exposure with the escort? Is it transmitted that way?
2) if i would contacted ngu or chlamydia would me and my wife be treated by now?
3) i have the feeling of discharge but when i am occupied i don't feel it for a while. Is this just my anxiety?
4) i am worried for pid with my wife. Do you think this is possible?
i am ashamed that i treated myself and didn't seek a doctor. But i freaked out due to the guilt and i was not sure that i was infected because i used a condom and i read that hand genital was not dangerous for infection.

Can you help me please.
Thank you

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help.  My approach is to first provide a general analysis and commentary on your situation, then address your specific questions.  The activities you describe are safe sex and do not put you at risk for any STD, including HIV.  Hand to genital contact, whether in the contact of masturbation of a partner or situations such as the one you describe in removing a condom are not associated with risk for any STD.  I realize that this is often a surprise to many of our clients but this is the case and has a strong scientific basis both in terms of the fact that environmental exposure reduces the viability for STD pathogens and the fact that these sorts of transfer only transfer a tiny proportion of material from person to person when compared to the sort of exposure that occurs from genital-genital contact.  neither of us on this Forum has ever seen a case of any STD transmitted through hand to genital transfer.

Now for your specific questions:


1) i was scared for ngu and chlamydia due to the exposure with the escort? Is it transmitted that way?
No, there is no risk for NGU, chlamydial or any other STD being transferred in this way.

2) if i would contacted ngu or chlamydia would me and my wife be treated by now?
Yes, the azithromycin you have taken is recommended therapy for both NGU and chlamydial infection.

3) i have the feeling of discharge but when i am occupied i don't feel it for a while. Is this just my anxiety?
Men normally have a small amount of normal urethral secretions which are sometimes noticeable, particularly if they are aroused. This does not sound pathological at all.

4) i am worried for pid with my wife. Do you think this is possible?
Not from what you say.

I hope these responses are helpful to you.  EWH

[vincyng862]

I think doctor gives a nice advice! And with condom on and if it is used properly, we should have no worry for all STD. I guess this is what Doctor Edward means!

[Edward W Hook, MD]

For you to have epididymis is at this time would be most unusual.  Rather I suspect that you are attributing the scrotal discomfort  that most men have and overlook from time to time to your prior encounter due to continuing guilt.  If the pain continues and becomes steady or worsens you may wish to have your doctor take a look but again, I doubt that this is related to any infection you acquired from the encounter you described.  EWH

[1985male]

Hello doctor,

i posted to you a month ago, and i followed your advice. i didn't worry anymore until last evening. I had a strange feeling in my groin area and maybe in my scrotum. i started te feel my scrotum and left testicle and i have this annoying feeling now. When i touch or press my scrotum and testicles i do not have pain. But i am worried for epididymitis. Is this possible after a possible no exitsting chlamydia treatment with zithromax and doxy.
Or is it just again my anxiety and touching the area that causes this strange feeling in my groin and left testicle?

Thanks

[1985male]

Thank you so much doctor for your great work. Have i nice day

[Edward W Hook, MD]

Straight to your questions:
1.  I agree.  In fact it is not at all unusal for a bowel movement to express small amounts of urethral fluid.  I would not worry and to quote a statement I saw on our STD Community site- "time to stop the crotch watch."

2.  No, we have no evidence of azithromycin resistanct NGU.  I would not worry about this.  EWH

[1985male]

Thank you doctor for your quick response.

i am very ashamed about cheating my wife and i will never do it again. And maybe that is the reason why i have an irritating feeling in my penis and the feeling of discharge. The last monts i have been reading alot on internet about std's pid... And when i'am confident that everything is ok i don't feel much. But i'm very anxious and the slightest feeling i've got i start checking myself.
I have 2 extra questions:

1) Today i was nervous and i had this feeling of discharge and i got home and looked but i didn't see anything. That i had a bowel movement and urinated and when i checked my penis after i noticed maby something like discharge like pre eJaculatory fluid. But after all the antibiotics we took togheter me and my wife. I assume this is not an std. Maybe normal secretions like u said. What is your opinion?

2) i took zithromax 3 times the past half year and my wife last time. Would taking zithromax  so many caused a possible bacteria of ngu or chlamydia to become resistant in me and my wife? What is the effectivity of zithromax regarding chlamydia ngu?  

Thank you so much for your kind work