[Question #11210] Unprotected Oral

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16 months ago
Hi Drs,
Thank you in advance for offering up your expert advice. I am a 46 year old male and saw a female CSW seven days ago. I received unprotected oral sex. Everything else was protected by a condom. Five days later I began experience burning while urinating. The pain is at the very tip of penis and honestly feels more like an injury than something STI related. No discharge and no other symptoms. It isn't getting worse. Should I look into this more and get tested or give it a few days? Thank you again!
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H. Hunter Handsfield, MD
16 months ago
Welcome. Thanks for your confidence in our services.

As you apparently know, oral sex is low risk for STIs:  not zero risk, but much lower chance than by vaginal or anal sex. In general, pain alone is rarely a symptom of urethral/urinary STI in men; the main symptom is discharge. However, it is conceivable you acquired gonorrhea, nongonococcal urethritis (NGU), or herpes due to HSV type 1. But as just implied, lack of discharge is evidence against the first two, and if it were herpes, the pain would be worse and by now you probably would have had obvious herpetic blisters or open sores. An injury doesn't seem likely given the delay of 5 days before onset of pain.

It should be safe to wait 2-3 days and see what happens -- discharge, sores, or anything else. If not and the pain subsides, probably you can just let it go. OTOH, if it persists -- or if you'd just like the reassurance of knowing for sure -- see a doctor or clinic with experience in STI management. Or you could go directly to a lab for a urine gonorrhea test -- but that won't rule out NGU, which can be caused by normal oral bacteria. (Gonorrhea testing usually includes chlamydia automatically, but chlamydia is acquired very rarely by oral sex, if ever.)

Let me know how it goes. In the meantime, I wouldn't be seriously worried. I hope these comments are helpful.

HHH
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16 months ago
Thank you Dr. Handsfield. I did get tested after posting my question. It was exactly seven days after exposure and everything came back negative. So all good on everything except possibly NGU? Thank you again!
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H. Hunter Handsfield, MD
16 months ago
Yes, all good for gonorrhea and chlamydia, assuming you had a urine or urethral swab test. If no abnormal discharge from your penis in the next few days, you'll know you don't have NGU either. And in any case, NGU from oral sex is believed to result primarily from entirely normal oral bacteria, and it probably is harmless for affected men's sex partners. ---
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16 months ago
Final question and then we can close it out. Should I see my Dr and get antibiotics if symptoms persist and suggest NGU? Thank you!
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H. Hunter Handsfield, MD
16 months ago
If you develop urethral discharge, then of course you should see your doctor. But I doubt that will happen. If it doesn't, you'll have to make your own decision about care; as already discussed, the symptoms described so far do not suggest any STI.

That concludes this thread. I hope the discussion has been helpful. 
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