[Question #13622] Regrettable Night - Risk Assessment

2 days ago

53 year old male. About 7 weeks ago I received about 7-10 seconds of unprotected oral sex; no vaginal penetration, but our genitals did touch. Head to opening. Everyone knows what penetration feels like and that did not happen. No ejaculation. 6–24h later I noticed urgency/frequency, then weaker stream and mild burning at the start of some voids. Since then symptoms fluctuate: hesitancy, weak “meh” flow, hard to start flow, pelvic/groin/rectal/penile discomfort worse with sitting and driving better for a short time with warm baths and lying down. UA and culture normal (no WBC, LE, blood or bacteria), PSA normal, no discharge ever or fever. On tamsulosin and tadalafil with partial relief. Could this realistically be chlamydia/STD prostatitis from that encounter, or more likely BPH/CPPS/pelvic floor? Is it safe to have unprotected sex with my wife?

Edward W. Hook M.D.

1 days ago

Welcome to our Forum. Thanks for your questions. I'll be glad to comment.

The encounter you describe was virtually no risk for STIs, including gonorrhea and chlamydia. The reason that I say this with great confidence include:

1. Most people, even commercial sex workers, do not have STIs.

2. Even with unprotected exposure to an infected partner, only a small proportion of single exposures lead to infection.

3. Transmission of gonorrhea or chlamydia require penetration- no penetration, no risk.

4. Your symptoms are atypical for STIs- urinary frequency/urgency is not a sign of STI and STI symptoms are not intermittent- they persist or worsen over time.

5. The onset of symptoms at 6-24 hours is not characteristic of gonorrhea or chlamydia which typically take 36-48 hours or more to develop

6. Tamsulosin/tadalafill are not effective for the symptoms of STI.

Your symptoms are suggestive of prostate problems, most of which are non-infectious in nature or perhaps CPPS. Anxiety can certainly amplify symptoms'

I see no reason for STI concerns and no reason to avoid unprotected intercourse with your wife. If you have not already done so, I would suggest seeking the input of a urologist. I hope this information and comments are helpful. EWH

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1 days ago

Doctor Hook, thank you for your reply and reassurance. It seems this story has been told a million times before. I figured I was in the CPPS/Anxiety bucket based on a few things.......quick onset of symptoms, frequency and urgency, weaker stream, hard to start stream, stream stopping mid void, slight burn without discharge, testicle ache that comes and goes, clean UA and culture, testicular ache that decides to come and go. I still have some degree of these symptoms, but they take a day off when they feel like or sit in the background barely noticeable. Definitely annoying. The Reddit boards and an active mind would have you believe that you've caught everything under the sun. Nonetheless, thanks again.

Edward W. Hook M.D.

1 days ago

Thanks for your thanks. I'm pleased that my comments were helpful to you. EWH---