[Question #12715] Oral sex follow up

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5 months ago
Hello, I realize I'm back here within a few days regarding to my insertive oral sex incident with the concern of Hsvl. Terri had answered all of my questions pertaining to genital Hsvl. Since there is a limit to how many questions you can ask at one time, l'm back here again as a continuation from the last question thread. To recap from the last thread, I had received oral sex from 3 different women back in January of this year. The last exposure in January was on the 25th of January and about 17-18 days later which was on February 11-12th, I had felt a slight/moderate burn right underneath my urethra on the tip of my penis right after I had got out of the shower with the warm water dripping onto it. 
I took a closer look the next morning and noticed a small tear/cut right underneath my urethra and another small tear/cut to the left of it. It wasn't bleeding or discharge but it had stung a little when water or my urine touched it. The next 1-2 days at night time in bed I noticed a sharper pain, burn in that same area like it was at its peak. Terri had mentioned it most likely isn't Hsvl on my genitals because of the timing which was over 10 days for visible sores or lesions etc.
My question is if this could be early sign of Syphilis? I asked the woman if she had any STD’s and she said No. Sorry to be back here again, I know this is on a different topic than my few previous threads and just want to know if this could be from excessive masturbation or something else. Thank you. 
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Edward W. Hook M.D.
5 months ago
It's unfortunate to see you back here for the 2nd time in a week and the 9th time in the past year with continuing misplaced anxiety about STIs.  You seem to worry an awful lot about STIs and putative STIs (like hepatitis C which is almost never sexually transmitted).  This anxiety is misplaced.  Most people do not have STIs, most single exposures to infected partners do not lead to STI transmission.  Your focus on possible symptoms when more plausible alternate explanations fits what we call genitally focused anxiety.  

As Terri has already said, the timing of the tears you describe is most compatible with vigorous masturbation.  The onset was early for syphilis and as you've already heard, late for HSV.  Further syphilis lesions are typically circular and painless.  The chance that this is syphilis is close to zero.  If you need to prove this to yourself, you can test.   While conclusive testing in the absence of lesions can take up to 6 weeks, if the lesions have been there several days, a syphilis test would be positive.  If you choose to test, that will rule out that the fissures you describe are syphilis.

As you know, you have two follow-ups remaining.  After that, there should be no need for further questions regarding the encounters you describe.  EWH
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5 months ago
Thanks a lot for your input Dr. Hook. I feel better now. I never saw any circular lesions on my penis and as of right now still don’t. It’s just the slight tear looking skin part under my urethra that’s still there as of right now which could have always been there but I over reacted. I also realize that getting Syphilis is very unlikely from insertive oral sex. 
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Edward W. Hook M.D.
5 months ago
You are welcome.  EWH---
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5 months ago
And just to clarify out of curiosity… So 21 days not before or after is usually the time frame when it comes to noticeable symptoms for Syphilis. Is that correct? And one last thing to wrap it up. Is a rapid Syphilis test at a clinic conclusive at 6 weeks like a blood from vein Syphilis test? 
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Edward W. Hook M.D.
5 months ago
Final responses. On average the first symptom of syphilis, a shallow, painless, ulcer at a site of sexual contact called the Shanker appears 21 days following an encounter. This of course is variable.

And yes, at six weeks a rapid Syphilis test is conclusive.

This completes this thread. Please don’t worry. Take care. EWH.
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