[Question #3238] Unprotected Oral Sex-Asian Massage Parlor

38 months ago
I received uncovered oral sex from an Asian massage parlor worker on Dec 28th.  The worker used a wet wipe, (Clorox or baby wipe not sure) to wipe me down first and stung a lot.  After the deed was done, i have not felt any burning when I urinate, however i have had some itching after urinating post-masturbation/sex that has completely gone away one week after exposure.  I am very concerned that I contracted a STI from my single exposure.  Also in the mornings i have been checking for any drip/drainage and do occasionally see a secretion inside my urethra if I open up my hole and shine a light.  Usually it is white, or clouded.    On occasion I've been able to squeeze some amount out, albeit very little.  I also urinated into a cup and see some sediment/ debris.  At my at any significant risk for Chlamydia or gonorrhea?  Thanks Drs.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
Welcome to the forum. Thanks for your question.

Receiving oral sex is safe sex -- not entirely free of STD risk, but low risk for all STDs and zero risk for some. Most sex workers don't have STD; when they do, oral infections are much less frequent than genital; and even if infected, most oral sex exposures don't transmit them. As for your symptoms, they are not typical for any STD. If you had acquired gonorrhea it would have caused obvious discharge of pus, and usually painful urination, within 5 days of exposure. Chlamydia is one of the infections that is rarely transmitted by oral sex, if ever.

As for your drip/discharge, you don't have any. If there isn't anything obvious (outside the penis) when you awake in the morning, nothing during the day, and no stains in your underwear, there is no discharge. Such close examination will often detect traces of normal mucus -- either mucus secretions by the urethra itself, or left over pre-ejaculate fluid that is normally present with any penile erection, including normal nighttime erections that all men have every night. "Debris" in urine also is normal. I would strongly urge you to stop examining yourself so closely. 

So all indications are that you were not infected. If somehow I were in your situation, I would not be tested and would continue unprotected sex with my wife without worry. However, if you would like the additional reassurance of negative testing, I would advise a urine test for gonorrhea and chlamydia, which would be valid at any time (as I said, chlamydia is almost impossible but testing is automatic along with gonorrhea testingh). Also blood tests for syphilis and HIV after 6 weeks. Based on both the low risk of your exposure and lack of meaningful symptoms, I am confident all will be negative -- so stay relaxed as you wait for the results.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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38 months ago
Dr, 

Thanks, I really appreciate your help.  I had a few follow ups.  

1) I saw a doctor when I got tested and he did not notice any pus or discharge when he looked into the hole. He did however say I had a 50/50 chance, which i found to be a little strange than said that I have an std soley based off me saying I noticed a "discharge in the morning."  I called my regular doctor, not the Patient first one, and he gave me a similar response to you. Any reason why the Patient First doctor would take such a strong position, or is he just trying to get me out the door.    

2) How noticeable would the burning sensation and drip be?  I am uncircumcised and am slightly worried that it throws off any visual cues on my end and also a bit of a hypochondriac and feel like I have a burning/itching sensation on occasion .  

3)no wife, but a long term girlfriend, any reason to bring this up? Numerically I put myself at a less than 1% chance am I assessing this right?  

Thanks again

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
1) The way you described your symptoms above, I do not believe you have or ever had any discharge. But if the first doctor thought otherwise, i.e. if you told him you had discharge, his comment was not inapparopriate.

2) My comments above say that any real discharge is easily noticeable. You don't have to look for it, especially with a flashlight! Also, painful is usually obvious. I'm pretty confident your "burning/itching sensation on occasion" is just your anxiety over all this magnifying trivial symptoms or normal body sensations that you otherwise would ignore or not notice.

3) I see no reason to say anything to your girlfriend. The chance you have anything from the oral sex event is way under 1%, probably more like on chance in thousands.

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38 months ago
That’s doc, let’s put this to bed. Appreciate the help and prompt response 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
I'm glad to have helped. Take care and stay safe.

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