[Question #6152] Gonorrhea/GI symptoms

16 months ago
Sorry to be back. In summary, I received brief oral sex and analingus from a massage woman in March of 2018. 2.5 weeks out I developed symptoms of prostatitis, which I still deal with today. I have been tested via urine out until 7 months post exposure, and even did an anal swab at 11 months past, all negative. My concern lies with my GF. She has experienced stomach pain over the course of this time. Her gallbladder was removed due to minimal sludge. She has had a random fever for a few hours once. And now, 1.5yrs afterwards, she is again complaining about stomach cramping. I am concerned if untreated Gon that may have infected the prostate via analingus, is in my semen and has infected her. Is that possible? If so, would my urine tests for Gon have been positive long ago? I have recently had cbc bloodwork done and everything looked good. My only symptom is slight pain after urination at times, and consistent pain in the anal area. Does this sound like PID for her? She says it doesn’t feel like her ovaries, but more her stomach. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
16 months ago
Welcome back, but I'm also sorry you found it necessary. This seems to concern the same exposure that led to your three threads a year and a half ago. Looking back at those discussions, I don't see much to add at this time. As I recall, you were conclusively tested for gonorrhea and other STDs at that time, and apparently even more recently. There is no such thing as persistent gonorrhea or chlamydia with negative test results. Also impossible for the prostate to be infected by analingus. (How would that happen? The rectum and prostate are physically near one another, but there is no connection between them.) And gonorrhea rarely if ever causes prostatitis anyway.

And I'm not convinced you even have prostatitis. If you do, it's not caused by any infection from the oral sex exposure. You might have not true prostatitis, but the chronic pelvic pain syndrome (CPPS), which is often caused by genitally focused anxiety or triggered by it. Google CPPS (spell it out) for more info; the Wikipedia article is good, as is information you can find from the Stanford University Dept of Urology.

Finally, your girlfriend's symptoms are not suggestive of gonorrhea or any other STD. Of course "stomach cramping" is an exceedingly common symptom, with innumerable causes that rarely if ever include gonorrhea or any STD.

It is clear you remain obsessed with a sexual decision you regret. But you have no infeciton from that event. Try to separate your regret, anxiety and perhaps shame over that event from potential infection consequences of it. They aren't the same. Given the repeated proof you have no STD, it would seem logical for you to ask your doctor about referral for counseling on this issue, which I suggest from compassion, not criticism. Anyway, it might even help your CPPS/prostatitis problem.

I hope these comments help move things along for you. Let me know if anything isn't clear.

HHH, MD
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16 months ago
Thank you for your detailed answer Dr. I would never be in this place of worry if I wasn't still experiencing CPPS-type symptoms a year and a half later; painful anus, perineum, penis tip discomfort, and sometimes pain after urination. No discharge, and yes, negative  urine tests out to almost a year post-exposure. I was worried about the possibility of this pain being caused by infection, and migrating from perineum/anus to the prostate, and in turn infecting my semen. I am confident in my urine test results. 

I should add, the stomach pain my GF experienced quickly turned into an appendectomy. This follows a cholecystomy which was only about 6 months prior. I was extremely worried it could be PID, perhaps still so if the surgeons wouldn't be looking for that. If that information does not change your assessment in any way, and there is truly no fear whatsoever over semen/prostate infection that has not shown up on urine testing, please feel free to close this thread without the need for response. I assume you could understand my worry with such strong abdominal symptoms and the fear of PID. Thank you!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
16 months ago
These additional comments do not change my opinions or advice. If your partner's abdominal pain continues, she should seek medical evaluation:  all unexplained abdominal pain needs professional evaluaton. Almost certainly she does not have PID, but if she does, it has nothing to do with the sexual exposure you are obsessed about or your CPPS symptoms.

That concludes this thread, which must be your last one on these topics. Because this forum cannot help you further, and because of the policy about repeated anxiety driven question, future questions along these lines will be deleted without reply (and without refund of the posting fee). Thank you for your understanding. dSorry we cannot help any further. 
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