To the point 

30 married male

3 mistakes

1) unprotected oral July 2020 from make in a bar

2) both ways unprotected oral nov 2020 from diff guy after party

3) more oral with 2nd guy Jan3rd 2021

Jan 4th day after 3) I come down with frequent urination nothing else. But passing lots of urine every half hour and never feeling relief.

Go to docs who does a dip test of my first void urine - first void because I didn’t know any better all clear. Don’t mention missteps because I didn’t realise I was a risk.

Prescribed me doxy anyway as dip test not always sensitive to uti.

Take doxy for 3 days no signs of improvement internet reserch leads me to noticing I can get sti from oral and urination is a sign. So I order a online test kit. By time I get it it’s day 5 of doxy I take the test 2 days later all negative. Clam, Ghon, HIV, syph 

Happy days finish doxy and have sex with wife several times as symptoms also go.

Feb 2021 start with urination again call GUM who didn’t think I needed to go in as non specific symptoms and test I had good but they did send me another clym and ghon test. 

Went to GP as not Sti related according to GUM who did dip test on fvu and msu all negative sent both of for more in-depth urinalysis all clear I’m told.

Second sti test all clear. Symptoms go

Fast forward to April with no symptoms when o get a feeling that I am discharging and wetness but always dry and clear - no marks on black boxes is now 4 months since last misstep so I order another test for clym gon all clear - although I notice now my urine is cloudy. 

Symptoms go with negative test but come back two week later this time more severe pain in end of penis and a ache all the time. Call doc say it’s anxiety and prescribe me with some setraine. Symptoms go after a week and since then only mild discomfort now and then.

I worry I have something my wife and she keeps giving it me back.?

What do I need to do now going forward?

What’s my risks ?

Am I in the clear? Or is it best to fess up

Your initial inclinations were correct:  you were at low risk (although not zero risk) for any and all STIs. Oral sex isn't entirely safe, but is far lower risk for all infections than vaginal or anal sex. Second, your symptoms were not as suggestive of STIs as you came to believe or perhaps read somewhere:  most important, frequent urination is not an STI symptom in men. (The main research study that concluded frequent urination does not indicate urethral STI was done by my forum colleague Dr. Hook and his research team. However, it remains true that some sources do not understand this basic fact, and I have seen advice from seemingly expert sources indicating otherwise, so it's a common misunderstanding.)

Your later sensation of urethral moisture and perhaps discharge seems not to have been confirmed by direct examination, right? In any case, that came on much too late to be attributable to urethral infection related to the oral sex events described. And without observation of abnormal discharge, and increased white blood cells in your urethra, there is no basis to conclude you had any infection. Same for the discomfort you desctibe. I would wonder about prostatitis or the chronic pelvic pain syndrome (CPPS, with symptoms similar to prostatitis):  the sorts of discomfort you describe and frequent or urgent urination are typical. But neither of these is an STI or, in most cases, caused by any known infection. CPPS is indeed strongly associated with genitally focused anxiety, so CPPS fits with your recent doctor's comments along those lines.

Finally, your negative STI test results:  They are very reliable and show you did not have any of those infections at the time time(s) you were tested. Having had doxycycline before testing only a few days after the last oral sex exposure, it is conceivable you had acquired gonorrhea or other STI that was nipped in the bud, i.e. that you had been infected but it was cured by the doxycline. But probably not:  that doxy didn't help your initial symptoms is strong evidence they were not due to any infection. In any case, you can be completely confident you do not now havce any of the infections for which you were tested, and therefore nothing that can possibly harm your wife or any other sex partner(s) you may have going forward. You can safely continue your usual and normal sex practices at home!

In other words, I'm confident all is well. I anticipate your urinary/prostate/CPPS symptoms will improve as all this sinks in. If not, continue to work with your doctor(s) as needed to keep those symptoms in check. But I'm sure you have no infection from the events described. Reflecting on a likely anxiety component, I'll add that it's common for such symptoms to occur in men following a sexual decision they regret. If that's the issue here, deal with those feeings as needed (maybe even including discussion with your wife?). But don't confuse them with infection risk:  they aren't the same!

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

In fact I had an idea your response would be similar to that! I have read multiple posts on here that reassured me. I posted for two reasons 1) as I knew you could see my anxiety (oh which I have a lot of, always have) and I wanted to contribute to the continued work on this forum as you provided a fabulous service and it’s well worth the money.

Starting with follow up questions.

1) I’m assuming because I tested with the symptoms for clym and gon that it means that’s not what is causing it? Ie I never passed it to my wife for her to give it me back?

2) could I have cleared it myself and evaded my tests - this seams unlikely but may as well ask.

3) each time both 1st urination 2nd urination and 3rd penile discomfort wetness feeling the symptoms went as soon as I had the negative test confirmed! This I think almost confirms mine yours and my gp suspicion that it is anxiety based - I assume you agree? 

4) I have only been tested for wbc in uritha twice once straight after via dipstick and again in February via full urinalysis if I had a level of ngu would this have picked it up - like you said the onset of new symptoms in April seems too late to be from the misteps last year so didn’t bother doctors this time so at that time I had no tests - apart from clym and gon. 

5) when my symptoms came back in may by far the worst they have ever been pain in penis I also felt pain in bum and back - further quantify a diagnosis of CPPS ? 

Anyway my symptoms left me on May 10th ish and I haven’t had anything of significance since then! So this will probably be the last reassurance I need. It’s been a while of comfort it almost seems distant past. 

Oh and also in regards to your question about my wetness feeling ever been looked at - no it hasn’t not by any professional however I have checked quite closely myself and nothing that comes out of my tip.  It’s also worth noting that this happens in bouts of weeks ie first freq urination last a week second did 3rd feeing of wetness and discomfort lasted a week 4th lasted a week. This dosnt seem like an sti to you I assum.

Thank you!

2) The immune system clears most STIs even if untreated, but not within days. Your negative test results were conclusive, i.e. you were not infected at all and could not have infected your wife.

3) Yes, this sounds reasonable.

4) Urinalysis (dipstick) is a poor test for WBC in urethritis; proper testing requires a swab of the urethra and examination microscopically. But all the evidence still is strongly against having urethritis of any kind.

5) The discomfort/pain of CPPS or prostatitis is what is medically known as "visceral" pain, the same sort that occurs with intra-abdominal infections, liver disease, etc. Visceral pain typically is diffuse and fairly vague, hard to localize exactly -- and can thus be percevied in different locations. For CPPS and prostatitis, it can include the tip of the penis, the shaft, the lower abdomen, rectal area, or even as low back pain.

I didn't realize your symptoms cleared up over 3 months ago. Glad to hear it! I really think you can and should move on without any worry at all.

My GP told me that the lab test on my urine is as accurate as a swab that’s why he made me do two a first void to check for wbc in Uritha and mid stream for uti   - the GUM clinic tell me the same. They both did say that the dipstick is poor though. So that marries up. 

The GUM also told me they don’t do a swab unless I have either discharge and or painful urination - something I have never had - as routine now they test for clam and gon via urine and that is that unless I went on to develop further more classic symptoms which I’m told is now unlikely to happen.

And for people that they trust only oral has happened again they rarely swab. Not sure if that’s a uk think a local thing or a covid thing. 

Yep 4 months free of pain (coincides with 4 months worth of setraline go figure)  

I think I have asked all I need to know I feel in a much better place now and I think it’s time for me to quit googling, quit thinking what if what was etc and move on. How I do that is my choice and something i have to work with . But my biggest anxiety me causing problems to my wife seems to be a none issue helps.

Just so you know I have also tested for syph and HIV at 12 week so I have ruled that out although I’m sure you would have told me this was unlikely.