[Question #6310] Possible std or ngu

15 months ago
Hello. I’m 35/m/us. I had unprotected oral sex both ways with an escort. 2 days later I noticed blood on my semen and tried twice second one being more red. Went to the doctor 5 days (Monday) after intercourse. Doctor said possible prostatitis and put me on cipro for 14 days did an std test also. Urine I did was not first catch. I had to pee as I got to the lab and peed in a cup 20-30min after. Lab test showed neg on both urine and blood test. 5 days after being on cipro I had a really bad sore throat. Pain from swallowing, redness in the tonsils. Went to the prompt care following monday for sore throat. Checked for strep and urine again not for std. doctor said pharyngitis. Took me off Cipro and gave me z-pack for 5 days. Sore throat cleared after 5 days of treatment but I was in bed after having chills and a mild fever on day 3-4.  I thought I was clear. Week after that Monday after 3rd week from intercourse I noticed a dried secretion in my underwear after gym. I was worried and did not sleep. No other discharge after that I have been checking but my other half had told me something feels weird by her belly/abdominal area. 

What are the chances I have contracted an sti or possibly a NGU. I feel fine. I never had any major pain when peeing. A slight feeling sometimes that I feel like I have small kidney stones coming out of my urethra. No lesions or bumps.  Thank you 
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

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

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15 months ago
Thank you very much for your quick informative reply. I do have a few more concerns though. 

1- how important is first void? As I have mentioned I peed right when I got to the lab. So I had to wait 20-30 minutes to produce urine again for the test. Does this change accuracy of the reading? 

2- the dried secretion I found approximately. 2.5-3 weeks after intercouse. Does that mean anything? I have not had sex since 2 days after  my oral intercourse with the sexworker.  

3- I have been in so much stress due to this and I feel like I have felt every single tingle on my penis since this has happened. I sometimes feel like one or the other of my testicle hurts sometimes. Am I over thinking the situation? 

4- can you still transmit std even during incubation period. 
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

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

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15 months ago
I appreciate your help! It has been a stressful few weeks for me. This website is so helpful and all the doctors are very knowledgeable. Thank you very much and hope  you guys keep on going helping everyone. My results came on negative. 
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

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

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