- Does a negative gono test at 5 days also eliminate NGU possibility? Is there another test to take?

-Does NGU have distinctive symptoms or can it be asymptomstic? What is the typical timeframe, including the latest time symptoms would present?

- Current symptoms at day 9 past exposure: Off and on lower abdominal cramping. Weird feeling in genitals, no pain or discharge even when squeezing, normal urination. Slight penile sensitivity and feeling as if something could be wrong. I understand the over thinking probability; would symptoms be beyond a “weird” feeling as if something is off? 

- Is there any risk to resuming relations with my gf, or is there a later date I should be holding out for?

- If symptoms do indeed present themselves, is NGU always considered sexually transmitted or can it be considered a urinary tract infection?

"- Does a negative gono test at 5 days also eliminate NGU possibility? Is there another test to take?"  See previous reply:  there is no specific test for NGU. A negative gonorrhea test says nothing about NGU.

"-Does NGU have distinctive symptoms...? What is the typical timeframe...?" Discharge from the penis is the main symptom, onset usually 1-2 weeks, but maybe sometimes longer asymptomatic cases probably occur but there is no research on it. NGU not due to chlamydia usually is harmless, as are cases acquired by oral sex (see your other thread).

"Current symptoms..."  Your current symptoms do not even hint at NGU or any other STD. They are, however, typical for genitally focused anxiety, not for any infection of any kind.

Risk for partner, etc:  As discussed last time, you had a low risk exposure, and the risk to your regular partner is low to zero. If want slightly additional reassurance, you could visit a doctor or clinic (who understands urethritis and STDs) for professional exam for signs of NGU (discharge, urethral swab for white blood cells, etc) -- preferably done at a time when you haven't urinated for at least 6 hours. If exam is normal and no elevated WBC, that's the best that can be done to excluce asymptomatic NGU. Or you could just wait until ~10 days have passed, and resume sex with confidence at that time. As also discussed in your other thread, NGU from oral sex probably is usually harmless to both affected men and their partners, so truly nothing to worry about.

NGU is always an STD. Some doctors don't understand this and NGU is sometimes misdiagnosed as UTI. However, UTIs are uncommon in healthy younrger men (under age 35-40), and in any case never are the result of sexual exposure.

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

HHH, MD

Anyhow, I thank you for answering my questions and as my final post here: 

1) Cramping in the abdomen and around the flank towards the lower back would not be considered a sign of infection without any other symptoms, correct? I read chlamydia or UTI possibility online, however I have seen your position that it is very low risk, not even worth testing. Just wanted to confirm that as I don't usually have low-grade cramping come and go throughout the day. 

2) In the absence of obvious, primary symptoms such as discharge, at day 10 post-exposure with a negative gono test result, can I confidently move forward without even thinking of this again, leave this site be, stop wasting time over-analyzing and move on!!?? I guess NGU crept in as a real possibility and that's where I got hung up again. My apologies. 

Thank you again, and sorry to be repetitive. 

1) In men, abdominal aching, cramping, etc is never a sign of an STD acquired by genital contact. There is no anatomic connection between the lower genital tract and the mid- to upper abdomen, so there's not even a theoretical reason such an infection could cause symptoms like this. UTIs in men are rarely if ever acquired sexually, except sometimes after unprotected anal sex. However, abdominal discomforts and cramping often are physical manifestations of stress or anxiety, so in that way your symptoms could be connected with the sexual exposure described. But not because of any infection from it.

2) Indeed, without moret typical symptoms you indeed can "confidently move forward without even thinking of this again, leave this site be, stop wasting time over-analyzing and move on".

Does that help a bit further?

A quick clarification; you mentioned wait ~10 days to resume sex with my regular partner. My assumption is that recommendation was 10 days total, or was it 10 additional from where I was at that point in time? I am currently 14 days past exposure and have not yet had sex at home (reminder, negative gono test at day 5).

My only symptom is a bit of penis tip irritation, varying in noticability throughout the day. At times I tend to notice it, sometimes seemingly more prevalant, and others I do not at all. Urinating is not painful, like razor blades or anything, although maybe I feel the first dribble a little more, and I have zero discharge or underwear stains. But the area does feel irritated, which as you suggest, and I hope,  could be mental manifestation. Would this irritation be enough of an indicator to treat? I can’t see how anxiety can be the sole reason of irritation. I’ve considered just going to an Urgent Care facility and requesting azithromycin out of an abundance of caution to my partner. Overkill? Without discharge would I be wasting everyone’s time?

Finally, you mention NGU acquired from oral means is presumably harmless. If I did indeed have this, and I passed it to my partner, are the symptoms similar to other std’s in women? Would she experience obvious discharge, pain, etc?

I’m at 14 days, when should I consider the max time has passed for the probability of NGU to be present? 20 days? Now? I’m afraid sex at home can wait no longer, but of course I’m terrified, although I know NGU in his setting is generally harmless. No discharge = no infection at this point?

Thanks for reading my final question and my apologies for the over-analyzation. 

10 days is from exposure.

By "harmless", I meant she would experience no symptoms, nothing would be wrong on exam, all tests of any kind would be normal, and there would be no serious outcomes or complications of any kind. Her risks would be no different than from you performing oral sex on her.

Nobody knows how long it might take for NGU to cause symptoms in rare cases. But most delayed symptoms are probably not in compulsively worried persons like you; most likely this happens mostly in the much more frequent sort of patient who isn't so worried and on the lookout for minor symptoms. Some men like that show up in clinic a month later, swearing their symptoms only began a day earlier -- but there is reason to believe they just didn't notice. In other words, I'm confident that if you had real symptoms, they would have been apparent by now.  For all the reasons we have discussed, there is no realistic chance you have anything at all, and even lower chance of anything that would harm your partner. It's time to accept the reasoned, science based reassurance I have tried to give and stop asking "what if", "yes but", and "could I be the exception" questions.

That completes two follow-ups and replies and so concludes this thread. Do your best to let this go. If you remain concerned, go back and read all my replies in both threads. And please, no additional questions about this exposure, symptoms, and your NGU worries! Thanks. But I do hope the two discussions have been helpful.