[Question #12836] Unprotected Oral Sex - Epididymitis afterwards

4 months ago

Hello, on 2/27 I received unprotected oral sex at a massage parlor. This was my 2nd experience like this other than one a year before. It included ejaculation and was a quick event.

The following day, I began seeing the following symptoms:
1. Discomfort in right testicle which has been building since.
2. Swollen Vas Deferens and Epididimys. (I’ve had Epididymitis several time before after my vasectomy so I know the feeling)
3. Urgent need to pee and often.
4. Feeling like more pee is dribbling out after urination. No thick or sticky discharge seen. Maybe a drop or two of pee in underwear.
5. No fever
6. Hip\groin pressure while sitting. Especially on the right side.
7. No blood in ejaculate.

8. Urine looks normal and clear.

9. No strange bumps or anything that I can see on or around penis.

I took the following actions which I now know may have been ill advised for some:
1. 2/28 - Started 7 days of Amoxicillin 875mg twice a day as I had it on hand.
2. 3/11 - Took 1G of Azithromycin
3. 3/23 - Started taking OTC Naproxen to help with discomfort
4. 3/25 - Mailed out a completed 3 in 1 STD kit with a sample for Gonorrhea, Chlamydia and Trich. It arrives on Monday of next week and I hope to have results next week.

My wife and I have had protected sex twice since.

Based on the info provided. Can you help me understand my risks for STDs? (HIV, NGU, CHM, GON and others) Am I presenting actual STD symptoms? What should I be concerned about? As you can probably see I overthink these things and my anxiety is getting the best of me. I am worrying about destroying my marriage and family. Any information would be greatly appreciated.

4 months ago

I'd like to add one clarifying statement. There were two events. 1 year apart. The latest was on 2/27/25. Both were unprotected oral. After rereading my initial statement, I could see where it may have been confusing.

Edward W. Hook M.D.

4 months ago

Welcome to our Forum. Thanks for your description as well as your clarification of the timeline. Your symptoms are suggestive of epididymitis but I suspect they are unrelated to the receipt of oral sex you describe. Having taken antibiotics apparently has not helped and may obscure what is going on. Your problems are best managed by a urologist, particularly if you had had similar episodes in the past. Both prior epididymitis and vasectomy can predisposed persons to recurring epididymitis due to the scarring the may follow the procedure..

Regarding the possibility that your problems are related to your receipt of oral sex, let me tell you why your current problems are untreated:

1. Your symptoms began too soon after your exposure to be due to an STI acquired during receipt of oral sex. typically symptoms would begin 3 or more days following acquistion of infection.

2. STIs following receipt of oral sex are quite unusual. Gonorrhea or non-chlamydia NGU may occasionally occur and when they do, infected persons are typically symptomatic with discharge and burning on urination.

3. Urinary frequency is NOT a sign of STI urethral infection. It may be a manifestation of anxiety

I hope this perspective will be helpful. I anticipate that your urine tests will be negative. A urinalysis may also be helpful but, as I said in my initial comments, this is a problem best managed by a urologist- not by self-medication or self-testing. EWH

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4 months ago

Good afternoon Dr. Hook. Thank you for your help with the information below. It has significantly helped to calm my nerves.

I have two updates:

1. I have a pending urologist appointment next week for the Epididymitis.

2. My lab results for Gonorrhea, Chlamydia and Trich came back as negative. All were tested with NAAT testing and no evidence was seen of any of the 3 per the documentation.

Based on these results and your comments, I do have a few of follow-up questions:

1. I mailed out the test on the 25th after taking Azithromycin on the 11th. If I had Chlamydia and it was cured by the medicine, would it still show up on the NAAT tests?

2. Should I have any concern that the antibiotics messed up testing?

3. Does Azithromycin cure Gonorrhea? (This is just me being curious)

3. Should I have any concerns about HIV or Syphilis? I am thinking no based on what I have read on your site, but want to be sure.

Thank you for all of your help.

4 months ago

Good morning, in the last couple days I have noticed a new occurrence in my body. My throat feels like there is something in it and there seems to be a white coating on much of my tongue. It pretty much scrapes off though. I did notice an oval 2/3 of the way back on the right side of my tongue that has a red edge and white center. It is maybe 1/2" by 1/3". It is not leaking or oozing. There's no recess in the middle. My mouth overall does feel very dry and cottony pretty much all the time Based on my only receiving oral sex from the masseuse 5 weeks earlier, should I be concerned?

1. Could this be Syphilis? If so, I never saw a chancre on my penis or balls, and I checked thoroughly. The timeline does not seem to match up with what I have read about a secondary infection of Syphilis.

2. Could it be just thrush due to antibiotics?

3. Is there any other thing that I should be considering?

Thank you for your help and advice.

Edward W. Hook M.D.

4 months ago

Welcome back. Your current symptoms are almost certainly unrelated to your receipt of oral sex sever weeks ago. What you describe may well be related to antibiotics if you are taking them. Specifically"

This sounds nothing like syphilis.

2. Could it be just thrush due to antibiotics?

That would be my first thought.

3. Is there any other thing that I should be considering?

You may wish to seek professional evaluation to determine if this is thrush. If so, treatment should help it to ressolve.

EWH

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