[Question #13953] GONORRHEA FROM RECEIVING ORAL SEX

1 months ago

First, apologies to Dr. Hook for panicking during my last question. I’m a 57-y/o male who received unprotected oral sex for 10 minutes from a female on 3/15. Lots of deep kissing too. I began feeling a tingling in my bladder about 17/18 days later and slight difficulty urinating. I recently noticed my right testicle is certainly bigger than the left, which led me to do some research and believe I have an irritated/swollen epididymis. However, the swelling seems to be the only symptom, no pain, NO pus/discharge and urinating is not painful. I’ve read one testicle is typically larger than the other, but haven't been examining until now. The swelling is less in the morning, more during the day. I am also coughing up some clear phlegm, no sore throat. So, my questions are: 1) Can the swollen testicle with no pain be the ONLY symptom of gonorrhea? 2) Is it possible that I contracted pharyngeal gonorrhea from deep kissing? 3) Might the swollen testicle be caused by an ordinary NGU?

H. Hunter Handsfield, MD

1 months ago

I'm sorry you felt it necessary to return. I truly understand your fears and concerns -- but that doesn't mean they are rational. They are not. Did you not read Dr. Hook's initial replies? Not understand them? Or just not believe them?

The risk of gonorrhea from this single event was probably under 1% (one chance in a hundred). If infected, the odds you would not have typical symptoms within 5 days was near zero. That you would go another 13 days without symptoms was zero chance for all practical purposes. The combination of those statistical odds means your chance of having gonorrhea is under one in many million. And your symptoms do not suggest gonorrhea anyway; they are typical for genitally focused anxiety, which clearly is the main problem here. As for a potentially swollen or tender epididymis, that's pretty much impossible -- and self examination and evaluation of minor symptoms is veryy unreliable. Coughing phlegm -- clear or otherwise -- is irrelevant.

The answers to your numbered questions are 1) No, 2) No, and 3) No.

Nothing is wrong. If you remain concerned, see your doctor. But forget gonorrhea and other STIs. You're fine.

Sorry if the blunt comments seem insensitive. Call if tough love if you like. But forget all this and move on. Nothing is wrong. See your doctor if you remain concerned. Good luck.

HHH, MD

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1 months ago

Thank you for the reply doctor. And again, my apologies for panicking. I did go for testing - was going to go before I replied to Doctor Hook for the final time, but the testing facility was closed. The results should be back by the end of the week. And I really do appreciate the "tough love". It helps! Its just that the symptoms, all be they minor, kind of got the best of me, particularly upon thinking back to the encounter, which was a little reckless. I've been dealing with some back pain too, which made me think it could have been related to the testicle/bladder, as well as some digestive issues and just feeling a little out of sorts when urinating. I suspect that you suspect my test results will be negative, yes? (I will post the results!) Thank you again for this wonderful service!

H. Hunter Handsfield, MD

1 months ago

No apology is necessary. Your symptoms still do not concern me; none of them fit with any STI. All of them sound mostly like anxiety or stress making you more aware of minor symptoms or even normal body sensations that every human lives with on a day to day basis. Yes, your test results will be negative.---

1 months ago

I received the result of my test, and as you predicted Dr. Hansfield, both GC/CT NAAT were negative and Syphilis Traditional Algorithm RPR Qualitative was non reactive - I assume its negative. I am still waiting on the HIV test, but do believe that will be negative as well. These were done with urine samples and an actual blood draw from the arm. Just a few followups if I may - 1) Are these results reliable at 4 weeks past the event? 2) If indeed I have a irritated/swollen epididymis, would it be caused by another STI/bacterial infection, or am I just imagining it? Again, I didn't start checking for symptoms until two weeks after my encounter, so I honestly don't remember if the testicle was always like that. (I know one is typically different/larger than the other & being older, I know things change below the waistline.) Thank you again for your replies and this excellent service!!!

1 months ago

And to add, I’m still experiencing lower back pain and not sure if that is in any way related.

H. Hunter Handsfield, MD

1 months ago

1) The GC/CT test results are reliable. 2) If you have to ask if you're imagining the change in your testicle, then almost certainly that's the explanation. Lower back pain doesn't fit with any STI.

You were previously advised of the policy on repeated anxiety driven questions. It was 7 years ago (question 4921), so you've had a pass on this and your most recent previous question. But just about all of them reflected very low risk events and your way out of proportion to risks. Thanks for your understanding. I do hope this and the previous recent one have been helpful. Best wishes and stay safe.

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