[Question #5997] Follow up - #5973

17 months ago
Hi Drs. 
Just following up on a previous question. I had been experiencing some general discomfort and itching at the top of my penis after a single unprotected oral sex encounter with a female. (Note, I have never had any discharge or pain when urinating. Also non-issue with masturbation.) I had a full STD panel done and all was negative. Nervous that this may be NGU, I took azithromycin. It's been 6 days since I took the medicine and my symptoms aren't gone. I went ahead and got another full STD panel done including Trich two days ago and all is negative. Do NGU symptoms typically take longer than a few days to resolve? Can I resume unprotected sex with my regular partner? Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Thanks for your follow-up and clarification of your symptoms.  On your initial post it was my sense that the discomfort that you were experiencing was an "itch" within your penile urethra.  It is now clear that your symptom was a superficial, surface discomfort.  Discomfort of this sort in no way suggests NGU and I apologize if I misinterpreted your initial description.  Sensations of the sort you describe in the absence of lesions are not suggestive of any STI.  On the other hand, they are typical of the process by which persons become aware of normal sensations when they focus on one part of the body or another.    I am not the least bit surprised that your two sets of STD tests were negative.  At his time, my advice is to put your misstep behind you, not worry further about it. There is no need for further testing, no need for treatment and no need to abstain from sex with your regular partner.  

Again, sorry for my misinterpretation of your initial post.  I trust this will clarify things and allow you to move forward.  EWH
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17 months ago
Thank you for your response, Dr. Hook. To be fair, your NGU diagnosis may have been accurate as the itching sensation I thought I was experiencing seems to have subsided since I took the antibiotic 10 days ago. Having said that, I continue to feel sensitivity at the head of my penis and a general throbbing throughout. I still have never had any discharge or pain while urinating, and definitely no legions. Masturbation not an issue either. It seems to feel normal when I wake up in the morning than gets more noticeable throughout the day...I'll admit I'm fixated on it. Needless to say, I'm nervous to continue sex with my regular partner even with two neg std panels. If it were NGU, wouldn't these symptoms be gone by now? Is there any other STD testing you would suggest for a single unprotected oral encounter with a woman? Do symptoms from a  surface discomfort take this long to get better?
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Again, my sense is that this may not have been, or in fact, is unlikely to be NGU.  As I mentioned before, focusing on a part of the body, looking for abnormal sensations not uncommonly leads to becoming aware of what are normal but overlooked and ignored sensations.  These sensations are often described as an "itch".  Given your multiple negative tests for STIs I would suspect this to be the case and see no medical reason for you to abstain from unprotected sex with your regular partner.  EWH---