[Question #4344] STD Risk from genital contact

31 months ago
Dear Doctors,

Although I have real several answers from Dr. Hook and Dr. Handsfield regarding apposition, as well as sharing of genital fluids, not representing risk of infection for STD's, I'd like to get your point of view regarding my exposure.

I went to a massage parlor where I was given a body massage. The masseuse's naked vagina rubbed up against the base of my penis for no more than a few seconds. At one point she also kissed/licked the middle of the shaft of my penis and sucked one of my testicles very briefly. There was no intercourse or direct rubbing of penis on vagina nor was there any oral sex other than what is described. Before she gave me a hand job she inserted her finger in my anus for a couple of minutes. Finally, I also inserted my fingers in her vagina and when I made myself ejaculate I know I had her vaginal fluids on my hand. 

Less than a week later I developed what I have seen in the past and consider a yeast infection (irritated skin around the glans and upper shaft), as well as a slight discomfort when urinating, although no burning. Five weeks later I developed a milky white discharge and burning sensation after urination. I went to the urologist and was asked if I had had unprotected sex to which I answered no and he prescribed Amoxicilin and Cefixime (2 weeks). The urinalysis came back with infection and the urine Culture was positive for E. coli. I have finished the antibiotics but still feel worried there might have been an STD involved. I might add I had sex with my wife almost 3  and 5 weeks after the exposure and had the discharge shortly after there second time. I don't mean to imply, by any means, anything regarding this, however, my questions are:

What are my STD risks
Is E. coli, common enough that I could of gotten if by normal vaginal intercourse with my wife (we don't engage in anal sex).

I am quite anxious and worried there might be something else.

Thank you very much for your help


Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome to our Forum and thanks for viewing our responses to others before asking this question.  One of our goals is to have the answers we write available to others so that they can learn and benefit from the information we provide.  The background key to the information I am about to provide is that our bodies are protected from infection by STI pathogens through the inherent resistance of intact skin to infection and the fact that pathogens must get "rubbed" (the friction does appear to be important) into the more susceptible mucosal surfaces where these infections occur.  It is for this reason that non-penetrative genital apposition, frottage, and even mutual masturbation in which genital secretions get onto hands and partners do not lead to infection and are considered no risk activities.  With this background, I'll address your questions.

The sort of kissing of the shaft of your penis and oral contact with your scrotum are considered no risk activities for the reasons noted above.  Similarly, there is no risk from any possible transfer of genital secretions that might have occurred as you were masturbating after inserting your fingers into her vagina (even if she was infected- remember most masseuses and CSWs do not have STIs to begin with). 

With regard to E. coli and your urinary tract infection, several comments.  E. coli is a widespread bacteria that most people have in their bodies and when these bacteria get into the wrong place they can cause urinary tract infections.  UTIs are more common among women than men however and when men develop UTIs it is sometimes important to ask additional questions.  UTIS most often occur in men over 40 as their prostate glands begin to enlarge. Might I ask your age?  Also, did your urologist check you for prostate infection?  If the symptoms have resolved, I would not worry further but I did think I should ask about your prostate. 

I hope these comments are helpful. EWH
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31 months ago
Thank you for your prompt response Dr. it is definitely reassuring. 

I am about to turn 41 years old and my prostrate was not checked, other than the labs I mentioned, though it is something I am fully aware of and will definitely Take up with the urologist.

I still have a distinct sensation of dripping or leaking, and though I have checked for any discharge such as during the infection, all I see is transparent fluid (no burning sensation during or after urination, but some “pressure” around the abdominal area). I don’t know if this is still normal after the 12 day antibiotic treatment or just the by product of my anxiety, possibly some colitis as well. 

Thank you once again


Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Thanks for your additional information.  I do think it is worthwhile for you to discuss this with your urologist, particularly in light of your improved but continuing symptoms.  Regarding those symptoms, my other observation is that on occasion when men have experienced symptoms, thereafter they tend to be "on the lookout" for symptoms of the sort you describe.  I wonder if this might be contribution.  I do. To think the symptoms you describe change my assessment as it relates to possible STI.

I hope the comment is helpful.  EWH
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31 months ago
I will definitely talk to urologist.

Thank once again, I appreciate your input and time.

Just to make sure, because I think it was a typo. At the end you wrote you DONT think the symptoms change your assessment, as it pertains to STI?
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Correct.  There were several typos.  It should have read: "I do. The symptoms you describe do not change my assessment as it relates to possible STI."   This does not sound typical of any STI.  Sorry for the typo.  EWH 
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31 months ago
I appreciate your kindness and expert opinion. 
I will follow up as you suggested.
Thank you for your valuable contribution to all of us who need help one way or another.
Cheers
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Glad to help. Take care. Please don't worry.  EWH
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