Hi Doctors, its been 3 weeks (21 days) since exposure. Sorry I'm returning back here after my last question. My concern last week was around analingus (I got swabbed tested last week, came back negative for Gon and Cylm) monday, i thought i caught something performing analingus, my throat issues have subsided quite a bit since results, anxiety was a factor i think. I connected with person and they said they were tested recently (Not sure when) for swab and blood and all clean. They massage others so i assume they may do this often. As mentioned, I also received 1-3 min unprotected oral briefly to completion and now i fear i may have either picked up NGU or Gonorrhea. I didnt take a urine test b/c up until This past monday (day 21) i didnt have system, Monday I started experiencing a slight burning/cold feeling in tip of penis. def feel it more after I pee and when I get some dribble in pants, wet heightens feeling and i feel it through out day, feels cold and wet with bunr. Urinating is hit or miss, i feed some slight irritation burning at beg and end but not during.

1. Based on my performing analingus, if Gon and Cylm swab was negative, should I be concerned with any other STD's of throat? this was at day 18.

2.. as for brief oral,  i haven't noticed any discharge, only issues are irritation/slight burning/cold feeling at tip of penis. I only look when i wake up or upon urinating  to ensure i dont over analyze , Should i get a urine test for Gon and Cylm if i didn't experience issues until 21 days?

3. AS for NGU, could it be NGU?

4. My wife just confirmed pregnancy and I feel i could infect her, should i be concerned ?

5. Are there any other testing i should consider or possible STD that could occur from my experience? 

6. Regarding NGU, is it NGU without discharge? My anxiety only went away for  a day when i got the throat results but returned once  i started feeling the irritation/slight burning/cold feeling at tip. Thoughts

Welcome back to the Forum. I'll try to answer but had a hard time following your question- I think there may have been some typos.

Typically the symptoms of urethral infection occur well before 10-14 days following sexual activity (receipt of oral sex in this case).  when urethral infection occurs, the symptoms typically are either burning on/during urination or the presence of a discharge from the penis.  When discomfort on urination is present, it typically is present with all urination, not intermittently.  Discomfort at the end of urination or at just the tip of the penis would not be suggestive of any STI.  With this as background, I'll go to your specific questions:

1. Based on my performing analingus, if Gon and Cylm swab was negative, should I be concerned with any other STD's of throat? this was at day 18.

No, I would not be concerned.

2.. as for brief oral,  i haven't noticed any discharge, only issues are irritation/slight burning/cold feeling at tip of penis. I only look when i wake up or upon urinating  to ensure i dont over analyze , Should i get a urine test for Gon and Cylm if i didn't experience issues until 21 days?

I would not be concerned.

3. AS for NGU, could it be NGU?

Occasionally, following receipt of oral sex, some persons acquire non-chlamydial NGU due to the presence of introduction of oral/mouth bacteria into the urethra where they cause irritation. This syndrome is not transmissible to sex partners and does not endanger them.  As far as testing is concerned, if this were NGU there would be detectable inflammatory white blood cells present ins a swab specimen or in a urinalysis performed on urine just as you begin to urinate. 

4. My wife just confirmed pregnancy and I feel i could infect her, should i be concerned ?

I would not be.

5. Are there any other testing i should consider or possible STD that could occur from my experience? 

No

6. Regarding NGU, is it NGU without discharge? My anxiety only went away for  a day when i got the throat results but returned once  i started feeling the irritation/slight burning/cold feeling at tip.

See my comments.  I doubt you have NGU.

I hope this information helps your follow-up questions.  Please let me know if I missed something or any part of this answer is unclear.  EWH

Hi Dr. thanks for quick reply, sorry for typos was typing from mobile. you can reference my last question Question #6322] Analingus follow-up for details if needed, you answered my previous questions. High level overview, analingus both ways and she performed oral unprotected briefly. Me 35 wm.

 

1.     Should I get any further testing, of so what you recommend?

 2.Should I go to DR for urinalysis NGU test?  Can a urinalysis for WB and other identifiers test be purchased at CVS, Walmart etc for self-testing without office visit? suggestions?

3.As for NGU, i know you said its usually introduction of oral/mouth bacteria into the urethra where they cause irritation. A similar thing and feeling occurred when I was exposed last year to a similar experience and im curious why every new oral exposure in my life didn’t result in these symptoms? I have had oral from a couple handful of people in my life and this only occurred twice, the past two exposures and never before and not with my wife, is there a rhyme or reason why it has happened most recently and not before with others? does it differ from male and female mouth gems, was the person sick with other infection?

4. If I had NGU, Does it cure itself over time and if so, whats the timeframe.

5. Could this be anxiety/ (CP/CPPS)?

6. overall, after reading your reply, are you saying there is not really any risk here and most likely no STD's and I can continue reg sex with pregnant wife without concern?

7. Oral swab for Gonnorhea only seems to be rubbed on tonsils, not sure if they rubbed back of throat, couldn’t tell. Would this still catch infection?

 

Any other ideas as to what this could be?

 

Again, thanks for all your assistance, much appreciated.

 

 

 

 

Hi Dr. this does help clarify the items for me.

A couple follow up thoughts.

1.     What therapy/medicine is best for NGU? Doxycycline, azithromycin?

2.     If I was diagnosed with NGU, should/would I have to inform partner since it couldn’t infect them?

3.     My current pain is focused in the tip of penis and when at rest/sitting/walking and rubs again underwear or pants, it’s uncomfortable/slightly painful. when I look down at penis, looks like the opening is slightly swollen sometimes like a halo around urethra, when erect not noticeable. Does this sound like NGU/ urethritis or anything else?

4.     Urinating is uncomfortable sometime, not all, I try not to think about it but when I start peeing. There is a lil pressure build up, not a bad burning sensation.  During urination, no real feeling, but at end its sensitive and feels wet and cold like a wet body part in the cold beeze. I had a scope down urethra last year, afterwards that really burned for awhole, would the burn be like that if it was NGU or Gonorrhea, or is NGU or Gonn mild?

5.     21 days is too long for Urethra issues to arise, would you agree? I was going to go back to DR Monday for Gonorrhea/ NGU, do you recommend against either test at this point?

6.     If it was NGU or urethritis, what the usual time the body will cure it naturally? It been 25 days so far from encounter.

7.     I read up on CPPS, kinda hits on some identifiers but not all, what’s the recommended therapy for this?

8.     How often do you see guys get NGU from ORAL, is this a common thing?

9.     Am I overthinking all this and shouldn’t be concerned?

Again, the person who I had the encounter was tested in Oct and clean for blood, swab and urine.

Thanks again for your support

Straight to your follow-up questions:

1.  Recommended therapy is either azithromycin 1.0 grams taken as a single dose or doxycycline, 100 mg taken twice daily for 7 days.

2.  Treatment of sexual partners of men with NGU is recommended. 

3.  This sounds like local irritation but does not suggest NGU.  (BTW, these sorts of changes can be seen in persons who are repeatedly examining themselves.)

4.  The burning of NGU is typically present all of the time, not intermittently.  The discomfort can be mild.

5.  It would be unusual for symptoms to occur at 21 days.  I think testing is a good idea.  I anticipate that your tests will be negative, at which time you should forget about any STI as a cause of the symptoms you report.

6.  NGU/urethritis symptoms can persist for weeks if untreated. 

7.  CPPS would fit.  I would suggest reading about it on Wikipedia where it is very well described.  Treatments vary although there is widespread agreement that CPPS is NOT an STI and does not typically benefit from antibiotic therapy.

8.  Precisely how common is hard to say but we do regularly see non-chlamydial NGU following oral. 

9.  My sense is that you are overthinking this, that you may have become somewhat hyper aware of normal genital sensations and may be irritating things with self-examination.  My recommendation is to go on and get tested Mon day as you plan.  If the results are negative, as I suspect they will be, then be reassured and put your concerns behind you.

Hope these replies have helped. this is my 3rd reply. Therefore as per Forum guidelines this thread will be closed without further replies.  Take care. EWH

I should have closed this thread earlier.  I will now.

You are in the clear.  Believe your test results! 

I would not be worried about either syphilis or HIV.  EWH