[Question #5230] Urethra / Ngu

22 months ago
Hello Doctor,

So glad that i discovered you on this new site and so sad that i have to come here!

29 years old male. Had unprotected oral sex at a message center for 3 minutes and i did not ejaculate on her mouth (i know its not a difference) i am pretty sure she do unprotected oral maybe 85% of the people there. I only had unprotected oral with my girlfriend, we are on 3 year relationship and i don't know why i did this to her, can't find the strength to tell her. Around maybe 3 days later i had a little burning sensation when urinate and also a discomfort and tingling. Whent for urine analysis and uroculture. Uroculture show E.Coli 10.000 bac, Eritrocite 8-10, Leukocite 5-6. I went to a urology doc and he said if you don't have any discharge we can't have a test. He said its a UTI and give doxcy for 15 days 2 times per day also an anti-inflammatory tampon. I finished the doxy 2 days ago. All this 3 weeks i didn't had any discharge. Has passed exactly 3 weeks from exposure and still i have this feeling after i urinate inside of urethra and a bit red at tip of pennis. What do you think, Urethra or Ngu ? I hope it is a easy UTI that will go away. I am not asking about other STD hoping that is near to zero to get with oral.

It is good to go for other STD test right now or i have to wait more days because i just finished the doxycycline.

Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
Welcome to the forum. Thanks for your question.

I agree with your urologist:  your symptoms, urinalysis, and urine culture all point to a urinary tract infection (UTI) caused by E. coli. Males can acquire UTI by insertive anal sex (UTI bacteria including E coli are abundant in the rectum), but otherwise it's not an STD. It is not likely you acquired it from the oral sex event a few days earlier. But even if you did, it carries no implication for your future health or for the health of your regular sex partner. Non-STD UTIs are not transmitted to partners.

I have no idea how to interpret treatment with an "anti-inflammatory tampon".  I have never heard of such a thing.

Most likely your continuing urinary discomfort is just slowly resolving inlfammation from the UTI. Without discharge, it is very unlikely you have NGU, especially after 2 weeks of docycycline. If you had been infected with gonorrhea, chlamydia, or NGU in addition to having the UTI, the doxycycline would have cured it. Doxy also would have prevented or cured syphilis if you had been exposed, so a blood  test would never become positive. For these reasons, there is no point in testing for any STD at this time.

Your mild continuing urethral discomfort probably will clear up soon, but return to the urologist if it does not. Also, you should ask your urologist whether you need eveluation for conditions that predispose to UTI in men. Males rarely get UTI unless there is a prediposing factor, like partial blockage of urine flow (prostate, urethral stricture), kidney stones, or sometimes congenital anomalies of the urinary tract.

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

HHH, MD
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22 months ago
Hello Doctor,

Thank you for your replay.

I have never had anal sex so maybe i have got E.Coli in others ways with towel from behind to pennis etc.

Regarding unprotected oral. The urology doctor gave me doxcycyline for 15 days. I finished doxcy on Saturday and Tuesday (3 days later) i went for urinalysis and uroculture and Wednesday (4 days later after i finished the medication) i made a swab test inside urethra. Is it okay for the time or i had to wait more long after finishing the doxy to make these tests?

Before the doxcy my urine test had Eritrocite 8-10 , Leukocite 5-6. Today  just got the tests and it say: Eritrocite 6-8, Leukocite 1-2. U

Uroculture test is negative, no more bacteria. Swab test show Mycoplasma, Ureaplasma, Neisseria gonorrhoea, Streptococcus agalactiae Negative.  All negative except Candida albicans Mykograma, which i have had a bit before.

From my exposure has passed 26 days. I have never had a discharge. Only discomfort from urethra, tingling, a redness irritation inside which i didn't have before, low Abdominal pain and not a good erection. I dont know how long should take till the total recovery of urethra inflammation.

I have had Hsv1 since child so im not worried. Hsv2 its like impossible as i have read. Syphilis also because i took medication. I am not sure about HPV. What about trichomoniasis, i can't find on the swab test. Regarding Gonorrhea Chlamydia, shoud i tell the clinic to make a urine test only for this ? Because i made a sample urine. I know this 3 weeks stress is so high and can cause a lot of things. Have lost 4 Klg, eczema on hand wich i have never have before etc.

I have tomorrow a visit with the urology doctor.

Thank you doctor and sorry for my English ( not my main language).

Wish you a good day!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
First, nobody gets E coli UTI because of how they use towels or toilets. That's an urban myth. And even the myth always applied only to women, never men.

In any case, as I said, this isn't an STD, which is the only topic we deal with on this forum. You should be asking questions about your recent UTI of your urologist. But retesting should be valid at the time it was done. 

It would be unusual to have more than one infection, i.e. an STD along with the UTI -- although it could happen. But there is no point in testing now for chlamydia, which would have been cured with doxycycline. Same for most but not all gonorrhea infections. As for trichomonas, it cannot be caught by oral sex -- the only sites of infection in women are vagina and rectum. You certainly could have a urine PCR test for trich. If done, you should expect negative results.

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22 months ago
Hello Doctor,

My last question,

So from this exposure after 15 days of Doxcycyline and without discharge but only the symptoms which i described before will you recommend me any testing for any Std, HPV or something else i should consider or not to worried at all ?

I appreciate you, Dr. HHH.

Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
Correct, I recommend no testing of any kind on account of this exposure. Of course all sexually active people should be tested for HIV from time to time, even if all sex was believed to be safe. So if you haven't had an HIV test in the last year or two, this might be a good time, while it's on your mind. But not because of this particular exposure.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope thie discussion has been helpful and reassuring.
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