[Question #6310] Possible std or ngu
15 months ago
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Edward W. Hook M.D.
15 months ago
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Welcome to the Forum and thanks both for your question and your detailed description of events and therapy. I have several comments but all culminate in the fact that there is almost no chance that at the current time you have an STI of any sort. Here are some comments in approximately the same order as they occurred in your post:
1. Oral sex. In terms of STI risk, oral sex tends to be lower risk than genital-genital or ano-genital contact. Transmission of infection is biologically inefficient and oral infections (as a source of transmission) are less common than genital infections. Acquisition of STIs from cunnilingus is rare and when it occurs, infection are typically asymptomatic.
2. Hematospermia. Blood in your ejaculate is a rare event with no association with STIs of any sort. In men over age 40 there is sometimes an association with prostate disease however nothing else you mention suggests prostate problems. Hematospermia is typically self limited, should it recur or persist, I would suggest seeing a urologist but would not worry about an STI. In terms of kidney stones, this is a different process but if you were having kidney stones it would be expected that you would have blood in your urine test.
3. Medications. Even if you had an STI, which is most unlikely, between the ciprofloxacin and the Z-pak, gonorrhea, chlamydia and NGU would have all been treated. More evidence that this is not an STI.
4. Sore throat illness. What you describe, as well as the relatively slow response to therapy (strep would have responded far more quickly) is most consistent with a community acquired, non-STI viral infection than anything else.
Hope these comments are helpful. I would not worry about the possibility of an STI and see no need for further testing. EWH
15 months ago
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Edward W. Hook M.D.
15 months ago
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Straight to your follow-up questions:
1. The 1rst void recommendation is arbitrary and the way that the trials to evaluate tests were designed. Studies conducted since then additional studies have indicated that the first void is not essential and that there is little meaningful difference in results.
2. I cannot tell you what the material you noted might have been but the timing is late for it to be an STI symptom and it would be most unusual for an STI to cause a discharge on a single occasion. I would not worry about it.
3. Absolutely. We regularly find that patients who are anxious or feeling guilty about a recent exposure tend to become hyper aware of what are otherwise normal sensations and tend to assign inappropriate concerns to them. Looking for sensations will lead them to be experienced.
4. Yes, STIs can be transmitted during an incubation period, before overt symptoms occur.
Hope this helps. EWH
15 months ago
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Edward W. Hook M.D.
15 months ago
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Glad to hear of your results. Thanks for sharing. Now it is time for you to put your concerns aside and move forward without concern.
As this is my 3rd reply, this well be my final response as part of this thread and the thread will be closed shortly without further responses. Take care. EWH