The next day after my second enounter with the escort I kept feeling a frequent urge to urinate, tingle in my testicles, and the tip of my penis would be watery when i pull the skin back. Went to get an sti check everything came back negative. Going for cystoscopy tomorrow. Now my girlfriend hasn't been showing symptoms. My questions are 1) could this be mycoplasma genitalium or an NSU from the oral? 

2) how likely is my gf infected and is asymptomatic? 

There is little chance you have any STD, either from the recent escort encounters or anywhere else, and even less likely you have M. genitalium. I'm not sure why that particular bacteria is on your mind -- my guess is you have been delving into the internet, without sufficient context to help you understand what you have found. That's not a criticism -- just a reality about the interet and how anxious people interact with it. Anyway, here are my thoughts:

As far as known, M. genitalium is not carried in the oral cavity and therefore never known to be acquired by oral sex. And no STD is transmitted by hand-genital contact, even if saliva (or even genital fluids) are used for lubrication.

Second, you have no symptoms that suggest STD. There are no urethral or genital STDs, including NGU (same thing as NSU) that regularly cause urinary urgency, or tingling in the testicles or penis. A little clear moisture suggests urine or scant natural mucus, nothing else; my guess is your anxieties are leading you to look too closely and over-interpret something that's always been there. Both this and your urinary/tingling symptoms are much more consistent with genitally focused anxiety than anything else. If the urologist (or whoever is doing the planned cystoscopy) found increased white blood cells in your urine or urethra, or if a urine culture was done and positive for a UTI bacteria, perhaps the cystoscopy will come up with something. But my guess is that it will be normal; and if not, it will have nothing to do with the sexual encounters described. To be completely safe, it would be reasonable to have a urine or urethral gonorrhea test (in fact, I would strongly recommend against urethroscopy (or refuse it) until and unless that were done and negative). (Chlamydia testing might also be done, since it's pretty much automatic at the same time as a gonorrhea test. However, chlamydia is almost never acquired by oral sex.)

Those comments pretty well answer both your questions, but to be specific to assure no understanding:  1) I am confident you do not have NGU, whether caused by M. genitalium or anything else. For sure not M gen.  2) Even if somehow you had NGU, when acquired by oral sex NGU has never been known to cause health problems in affected men's female sex partners. So your partner isn't at risk for anything at all. (Putting it at a personal level, if somehow I had been in your circumstances, I would not be tested, would not have seen a doctor, and would be continuing unprotected intercourse with my wife without the least concern for her health.)

So all is well. I recommend having a discussion with the urologist, and perhaps printing out this thread as framework, before proceding with cystoscopy. Unless there is other information you aren't providing (see above about urine WBC etc), I would judge the risk of an infection or other complication from the urethroscopy to be much higher than the chance you have an STD or that it will show anything abnormal.

I hope these comments have been helpful. Let me know if anything isn't clear. Best wishes--   HHH, MD

It's been a month and a half and my girlfriend doesn't have any symptoms. But im still considdrinh asking her to gettested. My worst fear in the world is her developing PID, and me being responsible. From what I hear MG is growing resistance to z pack and some to moxi which makes the situation scarier.

1) some users who did get the infection by oral got a PCR test to confirm the result, so how could they be misinformed? (I wish I could easily access this test but no one seems to know what mg is.)

2) Reading online urinary urgency is a symptom for mg or an nsu, but it's not the only symptom I have. My urethra feels bothered through out the day but I don't know if it's due to inflammation. I also get pain on my testicles but it goes away pretty quickly. 

3) What medication should I be taking yo get rid of these symptoms. Besides the depression I'm going through for thinking what I could've passed my girlfriend these symptoms are affecting my day to day life. Would z pack work?

4) Why is it difficult to believe an nsu or mg in specific can be passed by oral?

Thank you for your time doc I believe my questions are up. 

1) If someone had a positive PCR for M genitalium, probably it was valid. But that doesn't mean they caught it by oral exposure. If positive after an oral exposure, I'm confident it would have been positive before then. 

2) You simply can't believe everything you read online. I have done research on NGU and seen a few thousand patients with it. Few if any had urinary urgency. And urethra feeling "bothered" also is not suggestive. Your symptoms are typical of elevated pelvic muscle and bladder tension, which are not part of the NGU syndrome but are often due to genitally focused anxiety.

3) Sorry, but I won't help you treat something that I believe you do not have.

4) It'a not a question of belief, but scientific evidence.