1 year ago protected sex, unprotected oral. I also fingered her, then masturbated straight after.  I'm uncircumcised and not 100% sure if her secretions came into contact with the tip or urethra. 

I'm not sure how long after, I started getting symptoms. 

Irritation on tip, more so at the sides than the urethra. 

Occasional shooting/nerve tip pain in tip. 

Left side pubic area, where penis meets body swollen and sometimes hurts. 

I don't think there was any discharge. 

These symptoms would only occur a few hours after I ejaculated and last intermittently for 24-48 hrs. 

No blisters or sores, although tip sometimes a little blotchy, but that comes and goes within 24hrs. I had thrush a few weeks before, due to antibiotics for chest infection. 

I've had several sti urine tests, all negative. 

Saw GP, thought it's fungal, prescribed Daktacort cream. Made it worse. Foreskin very tight, hard to retract and irritation now happened randomly, not just after ejaculation. 

Also noticed clear watery discharge some mornings. I've checked during the day and it sometimes seems there is a tiny bit glistening in urethra in the light, not substantial amount. 

Saw consultant at GUM clinic last week. Did a urethral swab, came back clear. Checked urethra said it looked fine. Took a urine sample to test. 

My questions are:

1: do you think this is an sti? I spoke to consultant about mycoplasma genitalium, he said NHS don't test for it. Do you think this is a possibility?

2: is it worth testing for mycoplasma? If so, what is the best, most reliable type?

3: Would clear urethral swab rule out sti or mycoplasma, as no sign of urethritis?

4:if I had mycoplasma or sti, would symptoms be constant?

Thanks 

Condom protected vaginal sex is free of risk of any infections that could involve your urethra or cause the symptoms you describe. Unprotected oral sex is low risk for all STDs, although not completely risk free. However, I am confident your current problems have nothing at all to do with that event and I very much doubt you have any STD at this time. Although the recent clear discharge in theory could be due to nongonococcal urethritis (NGU), it is very unlikely you have had NGU all this time; most cases would clear spontaneously long before a year. More important, though, is your negative evaluation at the GUM clinic. Even though you're apparently awaiting the results of a new urine test (probably for gonorrhea and chlamydia), I'm confident it will be negative.

1. Mycoplasma genitalium is not carried in the oral cavity (several studies have addressed this, with negative results) and hence not a possibility following oral sex. Second, you don't have urethritis, based on the GUM exam and the urethral swab test plus careful urethral examination. If M. genitalium were causing your symptoms, these things would not have been normal.

2. And for those reasons, I don't recommend M. genitalium testing. (There are other genital mycoplasmas, but they are normal in the urethra and in any case also would not cause symptoms in the absence of evidence of urethritis.)

3. As implied by those comments, the answer is yes:  the clear urethral swab effectively rules out urethritis of any kind and hence any STI involving the urethra.

4. Yes, any of these would cause more or less constant symptoms.

All your symptoms are most consistent with anxiety magnifying trivial symptoms, or even normal body sensations, that you otherwise would ignore or not even notice. I imagine the GUM clinic folks said much the same thing, right? Do your best to go forward without further concern. Notice that I'm not denying you have real symptoms. Similarly, tension headaches are real pain, but we routinely accept that they can result from stress, anxiety, etc. The genitals are no different. You may have to just learn to live with them, but they don't sound severe and you can be certain they are not caused by anything that will ever harm you or your future sex partner(s). Once that sinks in and you come to understand this, both intellectually and emotionally, the symptoms may fade away.

So do your best to move on without worry. You have no infection of any kind from the sexual events of a year or more ago.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

To be clear, this is a different encounter to the one I spoke to Dr Hook about last year. This happened in May, but I ran out of words in my opening post so just said a year. 

I had put it to the back of my mind until I used the Daktacort cream and started getting the discharge, tight foreskin and the irritation started happening randomly. 

I also let my paranoia run away with me when my 5 year old son came in to urgently use the toilet just as I was finishing up. He said that there was some of my urine on the seat and it had got onto his leg.  He wiped his leg with tissue, then used the same tissue to dab the end of his penis before I had a chance to stop him. This terrified me that something could be transmitted to him that way and I panicked and decided to seek your help. 

If it’s ok, I’ve just got a few follow up questions please?

1: I know that condom protected sex is safe and I read up about mycoplasma not being in the oral cavity before I posted, I was mainly concerned with transmission through her genital secretions on my hand as I masturbated my self directly after I’d finished fingering her. You only mentioned about sex and oral being safe in your reply. Could you please clarify this is also safe?

2: Do you have any idea why the daktacort cream would’ve caused the discharge, my foreskin to tighten and generally made my symptoms worse? I went to my GP about it and he just prescribed me with another steroid cream, timolin or something similar was the name. I didn’t use this though as I was scared it would make it even worse like the original steroid cream did. 

3: Just for my information would what happened with my son be a viable route of transmission? My son is uncircumcised if that makes any difference. 

Thanks again for your reply, I really do feel a lot better since reading it and feel that I can move on now. 

2) Only guessing here, but Daktacort is a very weak corticosteroid but, like all steroids, could have triggered a yeast infection or allowed a nonspecific bacterial infection to progress, without enough anti-inflammatory power to help the resulting symptoms. In any case, nothing in this suggests an STD or any other infection from a partner.

3) STDs are never transmitted to children or other household contacts, despite shared toilets, showers, towels, eating utensils, etc. (Assuming no sexual contact, of course.) Your kids are not at risk current because a) you have no STD and b) it doesn't happen anyway. This is for sure nothing to worry about.