[Question #1849] STD Oral

44 months ago
Hello doctors: 

Here is my case. Received unprotected oral sex on Monday from high class transexual escort for less than a minute. Today I am feeling some burning fell at the tip of my penis (not while urinating, though). 

Have not seen any discharge whatsoever. In you medical opinion, does this warrant any kind of test? Or should I just return to my normal life of having sex with my wife. 

Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Welcome to the Forum. I'll be pleased to comment.   Among various sorts of sexual activity, oral sex is lower risk than genital or ano-genital sexual contact and only relatively rarely 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.

Having provided this information, given the fact that you have mild symptoms, my advice would be to seek a urine test for gonorrhea (and, although very, very unlikely chlamydia) before you return to sex with your wife.  While I anticipate it will be negative, it is the safest approach when we consider your symptoms.  I would not worry at all about HIV and syphilis is very, very unlikely as well. 

I hope this is helpful.  EWH


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44 months ago
Thank you, doctor Hook. 

So I went to my local doctor and he said he does not think its gonorrhea because of the absence of secretions  and took blood for a chlamydia test just in case. In the meantime, he prescribed Garamycin for common urinary infection and Trometamol for the pain. 
He also performed a urine test and said that for agonorrhea more specific test (no gonorrhea urine test in my country), we would need to take a sample of liquids coming out but there were non. 

Do you think the above is sound medical advice or do you recommend something else? The chlamydia blood test will be ready tomorrow. 

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

Have your symptoms continued ?   If not, I would not worry however I will share the following information with you:

1.  Garamycin is treatment for gonorrhea and would treat many urinary tract infections.   If you are continuing to have symptoms, this may be very helpful.

2.  Typically blood tests for chlamydia do not do a good job of diagnosing recent chlamydial infections but may tell you if you have had chlamydia in the past.  As I mentioned chalmydia is very, very rare following receipt of oral sex so I suspect that this in to the cause of your symptoms.

The most important question however is whether or not you still have your symptoms at this time.  EWH ..

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44 months ago
Thanks, Doctor. 
Yes, my only symptom which is a burning sensation in my urethra remains, but bear in mind I only started taking the antibiotics today. 
No pus or any other liquid coming out my urethra as of now. I will await for the test results and finished my treatment (3 shots of Garamycin). 
Still, I will go to a specialist on STI's on Monday just in case. 

Two last straightforward questions:
 1. From a statistical standpoint, if the unprotected oral sex is indeed the cause of the pain,  it would be most likely a non-chlamydial NGU, correct? 
2. A week after my treatment ends, and should it work, I can resume my normal life, yes?

Thank you and a pleasure speaking with you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Seeing a knowledgeable STD specialist is a good idea.  As for your follow-up questions:

 1. From a statistical standpoint, if the unprotected oral sex is indeed the cause of the pain,  it would be most likely a non-chlamydial NGU, correct? 
Correct.

2. A week after my treatment ends, and should it work, I can resume my normal life, yes.?
Yes, as long as your symptoms have resolved.  EWH
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