[Question #13056] Intercourse with condom, but with an incident

2 months ago

Hello, doctors.

I had vaginal intercourse with a woman, she is not a sex worker. We used a condom the whole time, but when I pulled out my penis there was a small hole of a few millimeters, a hole of maybe 0.5 cm. The hole was over the glans, the urethra was completely protected and the foreskin was also completely protected. I believe that if the hole was there during intercourse it lasted a few seconds, because I regularly checked the condition of the condom.

Browsing the forum, I saw some answers in which small holes or gaps do not pose a significant risk and that the biggest concern would be when the condom completely breaks.

Like this quote "Now, after reading the rest, you are not at risk of contracting HIV..And it appears that vaginal sex was protected by a condom: the small defect in the condom did not significantly increase the risk."

1- Is there a significant risk in an incident like this? As if it were intercourse without the use of a condom?

2- Or can I assume that it was safe sex despite the incident?

H. Hunter Handsfield, MD

2 months ago

Welcome back to the forum. I reviewed your discussion with Dr. Hook from a few months ago. I have to say I am perplexed that you have had yet another experience with condom with a hole.

Even without a condom, the large majority of sexual exposures do not result in STDs, even if the female partner is infected. You don't say how large the hole was, but if under 1-2 mm, only a very small amount of vaginal fluid could have contacted your penis; and unless the hole was at the tip of the condom, probably there was no contact with your meatus (the urethral opening). Therefore, probably this exposure can be considered to have been completely protected by the condom. Based on what I can tell from your question, it seems likely that you can safely assume the exposure was safe.

I have to wonder about the source of the condoms you have been using. I suggest you use only reliable brands -- if in doubt, a pharmacist probably can help you select the best options. You also might consider polyurethane or similar condoms, which are less prone to breakage and probably to small defects. Many men consider them to provide greater sensitivity and hence more sexual pleasure than latex.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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2 months ago

The hole was very small, probably about 3 or 4 mm. The urethral meatus was completely protected by the condom and the foreskin was almost completely protected. When I removed the penis and saw the hole, both the urethra and the foreskin were covered. As I said before, the hole probably remained there for a few seconds during intercourse.

These incidents with small holes also happened twice, but about 13 years ago. But I always heard a noise before that. And I always used condoms from famous brands. Maybe the problem is storage, but I've never had one that broke completely.

1- Can this event now be considered safe sexual intercourse? I've seen in some posts on the forum that complete ruptures, where the entire penis is exposed, represent an increased risk.

2- Would complete protection of the urethra be the main factor?

H. Hunter Handsfield, MD

2 months ago

Thanks for the additional information.

Condom protection is generally considered to mean that the urethral meatus and head of the penis, including the inside of the foreskin, are covered. You were there and I wasn't, but from all you have said I would consider this a safe exposure. On the other hand, you're always free to be tested for common STDs (gonorrhea, chlamydia, HIV and syphilis) if you remain uncertain and concerned.

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2 months ago

Thank you, sorry if I'm being repetitive.

I'm going to ask these questions to see if I understood correctly.

1- A small hole measuring approximately 4mm that was over the glans, but with the urethra completely protected and the foreskin also protected at the time of removal, can I conclude that the condom did its job?

2 - A hole of this size and for a brief period of exposure, was the amount of fluid that could have entered drastically reduced?

3 - What advice would you give if this were a case with a patient in your clinic?

And I asked the woman a few days later if she had tests, she told me that she had HIV tests and that I didn't need to worry about what had happened.

Thank you again and sorry for the inconvenience.

H. Hunter Handsfield, MD

2 months ago

If HIV is your main concern, the new information about your partner might be the most important consideration. People rarely lie about HIV status when asked directly.

1. Probably yes, but I cannot guarantee there was no risk.

2. Sorry, but I have no way to estimate the amount of fluid that might pass through.

3. The same as I gave you above. Probably little risk, but testing still might be something to consider for reassurance.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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