[Question #5651] Massage exposure

19 months ago
Hello Doctors, 

Exposure 1:  Handjob and fingering(brief with one finger) with massage lady. No self touching by both. So no exchange of fluids. But used the same hand used for fingering to wash penis with water one minute later. So that finger would hav touched the penis head.  Any risk here?

Exposure 2:  Massage lady was on top of me and rubbed herself rough on my penis for 30 seconds but she was wearing a normal cotton panty which completely covered her genitals. She also had a napkin/cotton attached to it inside as she was on her periods. I was wearing  massage underwear. But mostly penis could be out of it. I did not get any Erection during this act due to fear of place and first act of this kind. She then finished off with a rough handjob with cream and powder.  I did not see or feel any fluids from her underwear. But it was dark. 
Any risk from these activities?

4 days after second exposure i got very mild burning sensation in tip of penis. Out of anxiety i consulted few urologists. First urologist tested for urine test(not std) and ultrasound which is normal treated with Azithromycin, ceftrioxone, metronidazole and called it as PEP which had no effect. 5 weeks post exposure he prescribed steriod cream saying mild inflammation. I applied for 15 days and then consulted Second urologist who said its prostatitis(No tests done) and treated with doxy for 6 weeks. Also gave AF for 3 days and fungal cream for 1 week. Now its three months from the exposure and no burning sensation last few days. However mild discomfort at random times.

Request your kind risk analysis and guidance as i am going through extreme anxiety and put my marriage plans on hold. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. Some questions can be answered pretty accurately based only on the title of the question. Nobody ever gets any STD from massage, assuming the event doesn't include unprotected intercourse. 

And both exposures are zero risk base don your description, and your symptoms are not alarming. Based on these events, it was a serious overreaction to see "a few" urologists. I could understand seeing one doctor, but going for second, third, or further opinions was unneessary. In any case, with the multiple antibotics you have had, and continued symptoms, I am confident the symptoms are psychological, and that you didn't need any treatment at all. In any case, having seen several doctors in person, there is nothig I can add based only on your description. I am confident you never had any STD. I recommend having no further evaulation and no further treatment.

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

HHH, MD
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19 months ago
Thanks a lot for your response doctor.

The exposures mentioned in my previous posts are my only sexual exposures throught my life. 
I understand initial symptoms at day 4 may be anxiety driven. But i faced some real issues when days progressed like irritation after mastrubation/urination which is not happening recently. 

1.I had tested for all stds with urine at 4 weeks Also hiv, hepb and hep c at 42 days which is negative. HepB at 42 days is conclusive? 

2.Is there any realistic possibility of getting herpes in around 30 secs if she had any outbreaks outside the area covered by underwear (like thighs).Though i did not notice any. 

3. I started noticing change in bowel movement since this issue started. Not sure if its effect of those antibiotics. 33 days post exposure i got mild irritation and burning in anus. Gastroenterologist diagnosed it as mild anal fissure. 37th day when i woke up i felt a sharp pain inside my anus like something broke inside. It got cleared by evening. Is there any chance anal herpes is misdiagnosed as anal fissure.?

4. I never saw any bumps, lesions on or around penis/anus in this three months. Is there any chance first outbreak happen inside the anus without any exposure to anus. I had read in Dr.Terri post that first outbreak will always be in the area exposed. 

I dont like to get tested for herpes because of my anxiety and chances of false positives. 
Do u suggest me to get tested for the same? 

Sorry for getting this clarified even after you said not to worry about std. I had put my marriage plans on hold for these reasons.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
1. Those test results are conclusive.

2,4. Herpes is not a possible explanation for you symptoms, and HSV is rarely if ever transmitted by the kind of contact you describe. I can't say the risk is zero, but it's low enough to be ignored, especially since your symptoms don't match up with herpes. It is true that initial herpes occurs at the exact body areas exposoed.

3. No STD acquired by genital contact can change bowel habits. That's a typical sign of anxiety.

I have two reactions to "I dont like to get tested for herpes because of my anxiety and chances of false positives." First, you had all those other evaluations, which also have their risks of uncertain or false positive results. Why is your reaction and fear any more with herpes than other STDs? Second, you definitely don't need testing for HSV on account of the events described and I recommend against it. But don't be put off by the risk of false positive results. They occur for HSV2, but not all that frequently --  your results probably would be negative and reassuring.

It is nonsense to be delaying marriage on account of these semi-sexual experiences or your symptoms. You have nothing that could harm your future wife. I urge you to go ahead with your marriage plans on schedule.

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19 months ago
Hello Doctor,

As per your suggestion i tried to stop worrying.  Also my urethral symptoms are almost clear except for mild sensations rarely.
However i continue to have different gastro problems since last 3 months. I never had any before taking the antibiotics which the doctor called as PEP. (ceftriaxone  injection250 mg (Day 1),  Azithromycin 1gm oral(Day2)  metronidazole 2gm oral (Day 3, 5 200mg tablets same time) .   I am reading more about gut bacteria damage with antibiotics.  
1. Does the mentioned antibiotics have caused any damage to patients in your experience? 
2. If yes, do they cause permanent damage or i should be fine in some days. Though symptoms are better now considering last month. 
19 months ago
Posted by mistake before completion of questions.
3. As i read more about survival of hep b virus,  If i had come in contact with her fluid in the exposure described, can i consider hbsag negative at 42 days conclusive. I am worried about  this because of my bowel issues. If my immunity is affected by antibiotics and if i am not able to clear hep b incase i am infected. 
Sorry if i sound stupid with my questions.
Thanks for your support and guidance. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Hello again. These questions aren't stupid at all!

No worries at all about the antibiotics. Your GI symptoms have some other cause. The intestinal issues with these (and all other antibiotics) occur only while being treated. Azithromycin or metronidazole orally (but not ceftriaxone injection) could cause diarrhea or loose stools, clearing up within a few days of stopping treatment; or nausea in the hour or so after each dose. That said, an indirect effect of antiboitics sometimes is infection with Clostridium difficile (C diff), causing colitis with cramping, diarrhea, and sometimes blood in stools. But C diff rarely if ever occurs after brief or single dose treatment -- generally an effect of high dose antibiotics, usually intravenously for serious infections needing hospitalization.

Those comments address questions 1 and 2. If your GI symptoms, whatever they are, continue and/or you remain concerned, see a doctor. But there is no realistic chance they have anything to do with the STD treatments you received.

HBsAg negativitity at 6 weeks is conclusive. And as discussed above, no STDs (including hep B) are transmitted by the sort of contact you desccribe. And no, antibiotics have absolutely no effect on the immune system. Some antibiotics increase the risk of infections resistant to them (that's what's behind C diff, described above) -- but that has nothing to do with the immune system lowering resistance.

That completes the two follow-up questions and replies included with each thread, and so ends this discussion. I hope it has been useful. You can move on with no worries at all in regard to the semi-sexual events you have described. Do your best to let it go!
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