[Question #13639] Another encounter

1 days ago

Hello doctors, sorry if i came back again with the same question. My last encounter with CSW was 3 dec. I had unprotected oral, unprotected fingering (with possible cuts in my finger) and protected sex. During the same period, i was on an intense exercise (gym) and sports (cardio endurance), also high protein diet as well. On sunday, i suddenly got some UTI symptoms such as urgency and feeling of unfinished pee, as well as pain in pelvis/lower abdomen, But no burning nor discharge from penis. I also have some fatigue problem. My doctor told me it might be because i was dehydrated because i didnt drink enough water. I did some urinalysis and found that there also some (but small, still in the range of normal) bacteries in my urine. I also have severe fatigue for the last 5 days (from 10 of dec), and some parts of my body is quite in pain, eventhough i had rest for 3 days. My questions are :

1. What are the possible STDs that can i encounter? And what are the chances of infection?

2. Are UTI’s symptoms are typically the same as early symptoms of STD?

3. My doctors prescribe me pipidemic acid 400ng for my UTI since there’s still some bactery eventhough its in a small amount (normal testing amount is 0-26, while my score is 3.5). Is that enough?

4. Any other symptoms should i be worry about in the future prior to these?

H. Hunter Handsfield, MD

20 hours ago

Welcome back, but probably you have predicted my advice from the replies to your several previous questions. You know that unprotected sex is low but not zero risk and that fingering can be considered zero risk. The greatest STD risk from the exposure described is probably from vaginal sex, despite condom protection; unexplained STIs despite condoms are uncommon but certainly can occur. However, your symptoms do not concern me. "Urgency and feeling of unfinished" urination, these usually are not UTI symptoms in absence of painful urination, and absence of urethral pain and discharge is strong evidence against any STI. Fatigue and vague "body pain" also do not suggest any STD.

1. The main STI risks of importance are for gonorrhea, chlamydia and syphilis, but all are very unlikely.

2. As noted above, your symptoms are not typical for either a UTI or an STD.

3. Pipedemic acid is not approved for use in the US and I have no experience with it. However, it is related to the quinolones (like ciprofloxacin) and similarly effective. It would be reliable against most UTIs but not for any STD. However, the few bacterial found in your urinalysis do not suggest UTI, especially if no white blood cells were observed.

4. Absence of painful urination and discharge at this time -- more than 10 days after exposure -- is strong evidence against gonorrhea and reduces the likelihood of chlamydia -- and the likelihood of either of these was under one in a thousand anyway.

Since you're worried, you could consider a urine test for gonorrhea and chlamydia; and a blood test for syphilis in a few weeks. You could discuss it with your doctor. Almost certainly the results will be negative, but reassurance along is a valid reason for testing even when there is little or no risk. It's up to you.

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

HHH, MD

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9 hours ago

Thank you doctor. I think what I need is some education regarding sex and STDs, because its a taboo topic in my country due to religious and cultural background. Hence, may I ask

1. What kind of discharge should i be worry? Because i think discharges can be different with each STD. Also can the discharge happens at anytime, or only during pee/ejaculation?

2. If my urinalysis result said that i have no bacteria or small amount (still considered on normal range, more likely towards 0), can it be assumed i have no STDs? Or to screen STD, urinalysis are not recommended?

3. I forgot i had CPPS from several years ago. Can dehydration and (probably) injury excessive sports and lower abdomen workout contribute to my CPPS symptoms such as my pelvis pain, urging and unfinished feeling to urinate, and sometimes pain in testicle?

H. Hunter Handsfield, MD

23 minutes ago

This forum can't be a source for "education regarding sex and STDs"; whole textbooks have been written. Beyond the brief responses below, you can search online.

1. Abnormal discharge due to STD can be clear, mucus-like, or pus. It's present all the time, but often most obvious after several hours without urinating, especially early morning.

2. This was a normal finding on urinalysis. It does not fit with any STD or with UTI.

3. These symptoms, like CPPS, are most often just the result of anxiety, stress or worry making someone more aware of trivial symptoms or normal body sensations that otherwise would not be bothersome. They do not fit with any STD.

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