urethritis

[david2228]

Hi Doc

I was hoping you could help me with a query. I foolishly had a drunken encounter with a professional transsexual. We had mutual unprotected oral sex, no ejaculation. Since then I have been feeling very anxious as I am in a committed relationship.

7 days after the episode I went to my doctor and had tests for HIV (antigen), Hep C, Syphilis, and urinary PCR for c. trachomatis and n. gonorrhoea. at the time i was asymptomatic.

All these tests came back negative.

However since the tests I have developed some symptoms of urethritis, although not quite textbook. I have had a persistent burning feeling in the urethra, but not dysuria and some subtle testicular pain. No discharge. It should be noted that in that time I have had unprotected oral and anal sex with my usual partner which i guess could cause urethritis potentially?

Anyway, I have returned to my doctor who has performed a midstream urine microscopy and culture. I am awaiting any results from this.

My question is this: is there any risk that I could pass some infection onto my partner that might cause PID? are there other things i should be tested for? Could my symptoms be something innocuous? Should i just relax and forget about it? How sensitive is PCR urine? Could it be wrong??

Thank you Doc

[Edward W Hook, MD]

No, I would not recomend this sort of testing.  There is no evidence that either of these is transmitted through receipt of oral sex or even clear evidence that ureaplasma is a pathogen at all- it is present inormally in most men's urethras.

I would notrecommend empircal antibiotics wither- as I have said, it si not clear to me that you have an STI at all and antibiotics will only obscure the matter.  Again, my advice is to work with your doctor to detrermine what these non-STI symptoms are due to.  EWH

Once ag

[david2228]

Thanks- it should be noted that the development of symptoms was at 10 days post exposure. Should i get tested for obscure pathogens such as mycoplasma genitalium or ureaplasma? or would the basic urine culture be sufficient? should i take empirical antibiotics?

thanks!

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help.  The onset of your symptoms following your negative tests suggests that your current symptoms are not likely to be related to receipt of unprotected oral sex from your CSW partner.  Most CSWs do not have STIs and even when they do, most exposures to infected partners do not lead to infection (this is particularly true when it comes to receipt of oral sex which is less likely to result in infection than genital or rectal sex).  Further, as you point out, the symptoms you describe are not typical for urethritis.

The urine tests for gonorrhea and chlamydia performed on voided urine are highly accurate and should be believed- your negative tests prove that you do not have these infections.

At this point, there is no reason to worry that your current symptoms represent an STI acquired through the encounter you describe.  I would work with your regular doctor to sort things out but not worry that they are the result of your receipt of oral sex from your transsexual partner.  

I hope this comment is helpful.  EWH