[Question #10644] Gonorrhea or UTI
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21 months ago
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Dear Doctors. My symptoms are painful urination, minor watery discharge, painful penile shaft and red penis head. Also, I have mild bladder pain, which comes and goes. Symptoms began mild and worsened over 4 days. I consulted a doctor and am waiting for urine and blood test results.
7 days prior to symptoms, I received unprotected oral and then a handjob from a sex worker. Today, she said she is regularly tested and has no symptoms.
In the past, I have visited other female sex workers. Usually everything is done with condoms. Occasionally, I have received unprotected oral.
5 days prior to symptoms, I had unprotected vaginal and anal sex with my female partner, who isn't sexually active with others.
Also, the day before symptoms, I drove for 6-7 hours and become dehydrated.
What is more likely: gonorrhea from oral, UTI from anal, or something else?
Is there anything that can ease the pain from urinating? Due to the weekend, I won't receive test results for a few days. Any other advice? Thank you.
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Edward W. Hook M.D.
21 months ago
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Welcome to the Forum. Thanks for your questions and implied confidence in our service. I resume your doctor also examined you, not just ordered a test. Further he should have performed at least a urinalysis which would provide information on the presents or absence of white blood cells (WBCs) in the urine. Such information would be helpful in deciding upon expeditious treatment if needed.
Receipt of unprotected oral sex is relatively low, but not no risk sex. The most common STIs acquired from receipt of oral sex are gonorrhea or non-chlamydial nongonococcal urethritis (NGU) from the introduction of a partner's oral bacterial into the urethra. Either can cause burning on urination and a discharge although the discharge of gonorrhea is classically purulent. Anal sex with an non-STI infected partner can also cause NGU through the same mechanism. It can also cause a UTI.
It really should not take long for test results to be available- at least the urinalysis about also tests for a UTI or for gonorrhea. Treatment would vary depending win what the tests show.
Sorry I can't be more specific. EWH
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21 months ago
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Dear Dr Hook. Thanks for the fast reply. My blood test results are negative for hiv, syphilis, etc. One urine sample was negative for UTI. However, my other urine sample for gonorrhea and chlamydia was spoiled, and now I'm retesting for that. But given other negative results, gonorrhea seems likely. What's the chance I passed on gonorrhea to my partner in the 2 day window between seeing the sex worker (unprotected oral) and having unprotected sex with my partner? Does standard test for sex worker include throat swab? Maybe she doesn't know she has it. Also, my doctor is giving me antibiotic treatment for both chlamydia (pills) and gonorrhea (injection). Thanks again.
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Edward W. Hook M.D.
21 months ago
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My expectation based on the additional information you have provided is that your tests for gonorrhea and chlamydia will be negative and that you have non-chlamydial NGU as explained above. I anticipate that the medication you have received, particularly the doxycycline will help to resolve this problem although, of course you should follow up with your own physician. EWH---