Guess I’m wondering if you think I do have some type of std. Going for a 10 panel test today but anxiety is getting the best of me. Also my gf performed fellatio on me 6 days ago without me finishing and never had intercourse after. What are the chances she could’ve contracted something? She said she’s had a sore throat the last couple of days and thought shes getting sick but yesterday she said she feels better but she just keep having to clear her throat.  I can’t say that I’ve never felt the tingling or slight burning sensation when I urinate before but perhaps I’m trying to focus on it a bit now. 

As a generalization, the sexual activities you describe are low risk. While you do not describe when you had been in contact with commercial sex workers in the past, the sensations and findings you describe are not consistent with typical STI’s.  As a generalization, receipt of oral sex is a low risk activity for acquisition of penile STI’s and cunnilingus is still lower risk for acquisition of pharyngeal STI’s. Further, when the throat is infected by STI’s these infections are most typically asymptomatic.  Finally it is the impression of many clinicians that many oropharyngeal infections tend to be self-limited and go away after being present for a relatively short period of time (a few weeks). That said, we should never say never and for that reason, in addition to the 10 panel STI test that you were having I would encourage you to seek pharyngeal testing if for no other reason then provide you with a peace of mind that will come from a negative test Which is the outcome that I expect.

 1) Does it increase the chances of transmitting any STD if a male was to urinate right before receiving fellatio?

1.  There are no data as to whether or not urination prior to receipt of Fellatio (or any other sexual encounter) reduces the risk for transmission of infection.  While there could be a modest reduction in transmission risk, it would certainly not eliminate the risk as these infections are present within the cells of the genital tract as well as the lumen of the male urethra.

2.  Determining what proportion of mail STI’s are asymptomatic is sometimes challenging. There is no doubt that chlamydial infection or substantially less likely to be overtly symptomatic than gonorrhea.  As to whether or not symptoms are present, factors such as denial of the presence of an abnormality ( No one wants to believe they have an STI)  may play into detection of symptoms. It is clear however that it is not at all uncommon for experienced clinicians to detect abnormal urethral discharge in men who believe they are asymptomatic.

EWH