[Question #3377] New Risk. Not in relation to my previous.

36 months ago
Hi Doctors, 

I have posted before but this post relates to a new risk. 

Also I start counselling soon to overcome my visits to sex workers and also to address my anxeities. 

New risks- 

1) 29/01/2018- unprotected oral sex with Brazilian Escort in the UK. She told me she gets tested and is clean. No vaginal or anal. I ejaculation on her chest. No symptoms after this.
2) 17/02/2018- drunk condom protected oral and vaginal sex with a Romanian Escort/Prostitute.  She removed the condom at the end of the sex and gave me a 'hand job' till completion. I ejacualted on her stomach- her English wasn't great but she looked about 21/22 and stated "get tested by a  doctor". To my knowledge, the condom never failed. 
3) 18/02/2018- unprotected oral sex with an expensive british white Escort- I ejaculated in her mouth twice. She informed me she is tested every 3 months and in the years shes been escorting shes never had an STD . She seemed quite knowledgeable regarding STDs and informs she never has unprotected vaginal or anal sex.

My concern is today, one week after the encounters from the 17 and 18th. I felt discharge so I went to the bathroom and noticed almost "pre cum"  on the tip of my penis. Nothing cloudy or white. Also nothing muscus/creamy and no pain when urinating. It was like my tip was wet.  Almost like premeture ejaculation. 

In relation to the 3 new exposures how would you consider my risk?

Is my anxiety creeping in when i think "maybe the condom failed when i had protected vaginal and oral sex?" even though i never noticed anything of this sort at the time?

Should I be concenred regarding this 'discharge' I felt 7 days after my encounters?

I'm aware the above is low risk for STD's and 0 for HIV but i'm worried about this 'discharge' I felt. 

Regards, 

Jason. 
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Welcome to the Forum.  I will be glad to comment.  Let me first congratulate you on your careful approach to safe sex.  You are correct, there is no risk for HIV from any of the encounters you describe and, while there is little risk for classical STIs, there is some small risk.  Oral gonorrhea is uncommon and oral chlamydial infections are very rare but both do occur.  When oral sex leads to gonorrhea, the infection usually looks "typical" with an obvious purulent appearing discharge from the penis.  Fare more commonly, of all infections acquired from receipt of oral sex is 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 and is not readily transmitted to sex partners like other STIs, and in not associated with complications.  In the United Kingdom, many specialists do not treat NGU associated with oral sex.  When treated, oral sex-related NGU typically resolves quickly. 

The best way for you to sort this out is to get a test (urine or swab) for gonorrhea and chlamydia (I assume that they will be negative) and a swab specimen from the penis or a urinalysis from urine collected at least an hour after you last urinated and collected as the first few ounces as you begin to urinate, not from mid-stream one you have begin to urinate.  If such a sample is positive for white blood cells, you have non-chlamydial NGU most likely acquired from receipt of unprotected oral sex.

I hope these comments are helpful.  EWH

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36 months ago
Thank you Doctor Hook. 

I will aim to get tested this week as its been 8 days since my exposure so the results will be reliable. 

Without an obvious sore within the next week I take it I can rule out Herpes and Syphillis? 

Is there any long term complications from NGU? I assume like Chlyamdia the body's clears immune system clears it on itself over time?

Finally, if its ok with yourself, can I keep this thread open so i can return with my results? 

Best wishes, 

Jason. 




Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Testing is a good idea and yes, at this time your test results will be reliable.

From your description and particularly with the absence of lesions, I would not be worried about herpes or syphilis

Please remember, it is unlikely that your symptoms are due to Chlamydia.  If you did have Chlamydia however, complications in men are uncommon and are primarily epididymitis.  

We keep our threads open for 30 days after the last question from clients or until they have asked and had three questions answered.  You have ask two questions.  This thread will remain open, as per forum guidelines for. 30 days so you can post your results.  This is the case unless you ask another question.  If you do, the thread will be closed after the question is answered   EWH
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