[Question #2222] Concerned

46 months ago
Dear Dr Hook/HHH

I recently was traveling in another country where against my better judgement I engaged in an erotic massage. This involved lubricated masturbation of my penis by the masseuse with the foreskin lowered and taking a shower together. I want to understand if I'm at risk of HPV/HSV or Syphilis or any other STD and should I get tested. I'm really concerned as I'm going to get married soon and do not want to pass on anything to my fiancĂ©. Should I ask her to go for a vaccination  ? Any other precaution required ?

Best,
Roh.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome back to the forum. Thanks for this question.

I would advise you to re-read the discussion we had in connection with your previous question a year ago (question no. 640). As I said there, neither HPV nor any other STDs are transmitted by hand-genital contact. This event did not place you at risk for HPV, herpes, syphilis, or any other STD, and there is no need for you to be tested. You could not have acquired any infection that could be transmitted to your fiance. No precautions are required (on the basis of this particular exposure) in sex with your future wife.

As for your fiance being vaccinated against HPV, that's a good idea -- ideally all persons should be immunized against HPV, to prevent infection with the 9 types that cause the large majority of cancers and genital warts (or 4 types, depending on the vaccine routinely used in your country). But this advice is entirely unrelated to the sexual exposure described above. It is simply wise public health advice for all people.

Best wishes--  HHH, MD

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46 months ago
Dr HHH,

Thank you for your response.

1)  I just wanted to add that when I came back to my hotel I was very worried so I took a bath, shaved and applied anti-bacteiral+anti-fungal lotion on my Genital Area. While shaving I nicked by scrotum with minor blood coming out. Does that add any risk ?

2) Thanks for referring to my earlier question. I've seen in your earlier posts in MedHelp that information related to HPV is always evolving so wanted to confirm. I just wanted to get your take on the safety of this vaccination as I did see some concerns online. Also my fiancĂ© is 27 -  is it still okay to take the vaccination? Is it something that would be useful for me as well ?

3) I've earlier developed warts on my hand (tiny growth for years but did not increase or decrease - Burnt/Removed) and feet  (Salicylic Acid solution applied). Does that mean that my body does not have good immunity to clear genital HPV if I ever acquire during my lifetime ? 

4) Also I wanted to follow up on the earlier question  (#640) regarding the penile/scrotum pain. Post the 6 weeks of Ofloxacin treatment for "prostatitis" the penil (urination) /scrotum pain came back in mild forms 2/3 times in gaps of months. The urologist recommended that no further treatment is required and to ignore. This has eventually subsided with slight tingling feeling sometimes. I did separately get diagnose for Varicoceles through an ultrasound. Could that be an issue or do I need to pursue this with a STI/STD expert.

Best,
Roh.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
1) This makes no difference. Having had the contact with your partner while showering, no secretions or virus could still be on the skin afterward, even if there had been virus on her hands.

2) There are no concerns about safety of the HPV vaccine. Anything you find on line that calls the vaccine unsafe is from non-scientific sources. However, your fiancee is beyond the recommended age limit for HPV immunization (age 26) and should not be vaccinated.

3) This is an atypical descripion of hand warts. If not professionally diagnosed, probably they were some other kind of skin bumps. In any case, having longstanding hand warts does not mean you do not have strong immunity against HPV.

4) Most prostatitis (or male pelvic pain syndrome) is not due to an infection of any kind, which probably is why your symptoms persisted or recurred after treatment with ofloxacin. Antibiotics cannot help any non-infectious problem, except maybe by placebo effect. Varicocoeles cause no symptoms at all. I agree with your urologist and for sure you don't need to see an STI expert. That problem was not an STI and in any case it apparently has cleared up.
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46 months ago
Thanks for the responses. Additionally 2 questions which bug me about this incident - 

1. While showering the lady hugged me from behind (momentarily). While doing this her genital area may have touched my butt (though I think while standing the angle may not have been right to transmit anything I did feel something warm pressed against my butt)- Does that warrant any risk ?

2. Since yesterday I've developed pain in my testicles it started with the left and has now moved to the right. I also felt some pain in the tip of my penis. Can you please advise if I need to do any test/medication/treatment ?

Thanks,
Roh.
46 months ago
adding to the above questions -

3. So in- between these two incidences (post the ones in question 640)  one day day after swimming I developed lesions on my foreskin. I was wearing a net/mesh swimming shorts that day so I attributed that as a skin reaction or injury. After a few days I developed a lesion on my waist which was red, painful and left a dark/black scar (went away in a few days, max 5 days). Are these symptoms anyway related to these events ?

Best,
Roh.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
I think you're having trouble remembering or understanding the main take-home message from my replies both here and in your previous thread. No intercourse means no risk for HPV or any other STD. None. If your penis does not enter another person's vagina, rectum, or mouth, there will never be any risk for HPV, HIV, or any STD. Do your best to believe it. Knowing that, it should never be necessary to ask again about it.

1) Therefore, no risk.

2,3) And also therefore, any symptoms you have cannot be due to any STD from the events described above, or from any similar exposures in the future. Testicular aching, often with pain referred to the tip of the penis, is typical for genitally focused anxiety -- not an infection. Or perhaps it is residual discomfort from your past prostatis. Most penile rashes, including "red spots" on the foreskin, are not due to STDs, and cerainly the mark on your risk is not suggestive of STD. You can't go through life attributing every minor ache, twinge, itch, or other body sensation to these or other sexual events! No testing is necessary.

That concludes the two follow-up questions and replies included with each new question and so ends this thread. Do your best to move on without worry.

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