[Question #1381] Gonorrhea/NGU? Worried

46 months ago
I am a man that received unprotected oral from a female prostitute about 1 month ago. She asked me if I was clean and said she was as well (she said she was OCD about it). Oral lasted only.about 1-2 minutes. Next day had a sore throat. About 10 days later, PCP sent out Z Pack for sore throat. Throat was better, but penis started feeling strange. No discharge or burning on urination, but irritated at end of urethra, espespecially noticing it rubbing on underwear. It is pretty much constant and driving me crazy.

Went to PCP last week and 'fessed up; he looked me over and based on what I told him said it was probably nothing, but he gave me another round of azithromicin and doxycycline. 

After taking meds, I still feel the discomfort on the penis. Its probably all in my head, but I am married...and well, you know the rest (you've heard it a million times).

So...No. 1 - I see a small percentage of men are asymptomatic; could I have missed something?
 
No. 2 - If I had anything (gono/NGU), would the antibiotics have cured it by now? 

No. 3 - If/when can I have sex with my wife (we haven't since this incident)?

You do a great service. Thanks in advance...


Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago

Welcome to the Forum.  I'll be glad to comment.  Most commercial sex workers do not have STIs and oral sex relatively leads to infection.  When it does, the most common problems are either gonorrhea of non-gonococcal urethritis NGU) caused by mouth organisms introduced in to the urethra during sex.  This sort of non-chlamydial NGU is not clearly and STI in the traditional sense, is not readily transmitted to sex partners like other STIs, and in not associated with complications.  In the Unitized Kingdom, many specialists do not treat NGU associated with oral sex.  When treated, oral sex-related NGU typically resolves quickly with standard antibiotics (azithromycin or doxycycline) of the sort you have been treated with.. 

The discomfort and sensitivity you describe is not suggestive of any STI.  I suspect that following this exposure and your initial concerns and treatment that you have been inspecting yourself more closely than you had before the event.  In this context you are likely to "detect" normal variation and be a bit more sensitive to exposures than usual.  

My advice is to not worry further.  I see no reason for testing of any sort and no reason for you to continue abstaining from sex with your wife.

I hope these comments are helpful to you. EWH 


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46 months ago
Thanks Doctor for the response. Regarding the irritation I'm feeling at the end of my penis/urethra (which didn't start until after my encounter), you say it is not symptomatic of any std. Therefore, it would be safe to assume that if (1) I had a std, it would have been cured by the antibiotics by now and (2) if I never did, then this is all in my head? I'm not saying that it isn't , because the mind can do all kinds of things to you, but things just don't feel right down there. What do you recommend that I do? I guess I just want some kind of reassurance. I see all kinds of people on the various message boards obsessing for months and years, no matter how many negative test results they get. I don't want to be them, panicking at every turn.
Edward W. Hook M.D.
Edward W. Hook M.D.
46 months ago
More testing and more therapy is certainly NOT warranted - as Einstein said, "one definition of insanity is to do the same thing over and over again and expect different results" - you were not infected/  I would urge you to believe your tests and do your best to focus on other things.  Work to get by the guilt and perhaps shame you feel over this encounter.   EWH
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