I regretfully had 3 encounters in the last 4-5 weeks. I had oral sex on me and intercourse with a condom twice (4 and again 3 weeks ago) with the same escort and oral sex on me with a condom with another escort 5 days ago.

There was no unprotected sex other than touching with hands. In an occasion 3 weeks ago the escort attempted a lap dance and for a second part of my penis may have touched her outer labia or inner thigh. I need to sort out my conduct.

1 week ago I had sex with my wife.

I have been tested several times for chlamydia and gonorrhoea- the last test was 6 weeks ago. Negative pcrs.

For the last 3 days I have been having dysuria and frequency- I have started trimethoprim with some effect. 

I cannot understand how I could have contracted a chlamydia load or gonnococcal urethritis. I am hoping it is E. coli.

Can you comment on the exposures discribed and advise on my risk of std?

It is unlikely you have any STI, for several reasons. First, escorts -- by which I mean (and you probably agree) expensive female sex workers by appointment (as opposed to brothel workers, for example) -- generally are believed to be low risk for STIs. They often are health conscious, get tested frequently, and typically their partners are low risk themselves (i.e. men like you). Second, you describe low risk exposures, since oral sex is low risk (although not zero risk) for STI, and condoms are highly protective for vaginal sex. Finally, the fleeting penile contact you describe during a lap dance carried little or no risk.

As for your symptoms, dysuria and frequency alone rarely are due to STI:  that you have not noted discharge is good evidence that something other than an STI was responsible. And if you had either of these, or nongonococcal urethritis (NGU), the symptoms would have started within 1-2 weeks of contact, which seems to exonerate your escort events as sources. Further, your negative test results are highly reliable. For all those reasons, you are exactly right in questioning how you could have caught gonorrhea or chlamydia:  clearly you did not. Finally, neither of those would be likely to respond to trimethoprim.

So all the evidence is strongly against any STI. Non-STI urinary tract infections are uncommon in men, although the risk rises greatly with age beyond 40 or 50 (how old are you?). But even in younger men, UTI occurs from time to time, and your symptoms are typical; and so is the response to trimethoprim. (E. coli is the most common cause of UTI, but accounts for no more than 80% of cases -- any of several other bacteria are likely as well.) Have you been treating yourself without professional advice? If so, that was a rather serious mistake:  all confirmed UTIs in males need urological evaluation for anatomic problems that increase UTI risk, like prostate enlargement, kidney stones, and other conditions; and it's always a good idea to identify the particular causative bacteria and the antibiotic(s) most active against them.

In summary, I am confident you have no STI, or any other medical consequence of your extra-marital sexual events. But you need urological evaluation to assess why you have a UTI and potential steps to prevent future ones. I would advise you to see a urologist. 

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

HHH, MD

Scant urethral mucus or discharge can go along with your UTI. This doesn't change my assessment or advice.

I am 90% sure I had a dmsa as a child. I had a warming fluid injected while they took x rays. 

Thanks for all your good work

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.