I recently started a new relationship with a new girlfriend (exclusive) and decided to do a urine pcr (they test 7 stis) and also bloods for hiv, syph, hep, etc. 

All neg except U Parvum.

We have not yet been intimate sexually, except that she gave me oral sex a few days before I tested and she swallowed my ejaculate. 

Has anything changed in your views about UP? Does this need to be treated and if so, how? 

She has today complained about body aches, fatigue and sore throat but I think that may be coincidental. 

Could I have gotten UP from the oral? Do I need to inform her or just ignore and more on? 

Many thanks! 

I'm glad you recall our previous discussions. No, there has been no change in the evidence about Ureaplasma parvum:  it is an entirely normal bacteria in the genital tract and never needs treatment. I suggest you re-read the discussion in your thread 11 months ago, no. 7872. That concerned U. urealyticum, but everything there applies to U. parvum -- except that UP is even less likely than UU to cause symptoms or disease UU. And in any case, neither of these bacteria is known to infect the oral cavity, and therefore neither is ever acquired by oral sex. There is no need for treatment or to inform your recent partner.

Another aspect we discussed last time is the professional recommendations from various organizations against routine testing for UU, UP, or Mycoplasma hominis, even though these often are included in "comprehensive" STI testing panels. The position of the American STD Association, mentioned last time, has now been published; as have even more recent recommendation by CDC. In the event you decide to seek future STI testing, I suggest you select panels that do not include any of these organisms.

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

HHH, MD

Many thanks again for your ongoing support and guidance. 

Thanks for the thanks!

Just to be clear, and for context, my girlfriend and I are exclusive and we have only engaged in oral sex. I have had no other partners. She is a virgin and we will wait for marriage before engaging in sexual intercourse. Her last time giving oral sex was to an ex boyfriend 6 years ago. 

Now on 10 May I received oral sex from her and since then I have been feel discomfort in my urethra - no discharge, or burning urination but discomfort at the top post urination and it lingers and sometimes comes and goes. 

I did lab urinalysis at days 5 and 10 (day 5 was 1-2 wbc) and (day 10 was 2-3 wbc). Nothing else found. I assume this means no infection? 

I also did a culture and waiting for those results, and I think I will redo the sti urine pcr panel I did previously (it includes UU and UP because that's just the package deal they offer and its cheaper than individual tests for more serious pathogens).

Could my receipt of oral sex have activated symptoms of my UP? 

Also, I will visit my urologist this week to discuss, however if he decides to treat me, I assume my girlfriend will also need the same treatment? 

I guess it could be an NSU (though I would have expected higher WBC), my issue is she is my long term and hopefully forever partner and I don't want this to keep happening everytime we decided to engage in oral sex. 

Any guidance from your end would be greatly appreciated. 

Thank you again and have a lovely weekend ahead. 

I doubt you have NGU; If you do, it is not caused by U parvum. For NGU acquired by oral sex, In most cases the partner does not need treatment. I have to suspect the main problem here is overreaction to trivial or unimportant urethral sensations, perhaps anxiety-driven. For sure you do not need treatment if there is no discharge and/or white blood cells in your urethra.

New oral sex (e.g. new partner, or regular partner with no or infrequent prior oral sex) can introduce entirely normal oral bacteria into the urethra, a possible cause of the minor discomfort you report. If so, you can expect it to clear up soon on its own. And to stop happening if you continue to have oral exposures with your partner. When NGU is acquired by oral sex, the oral partner generally does not need to be treated, either for her (or his) own health or to prevent transmission of infection back to the patient or to anyone else.

As implied above, absence of WBC is strong evidence against infection.

I would have recommended against repeating culture or any other lab tests. You can expect negative results. If positive for something, almost certainly it won't be from the oral sex exposure.

There was nothing to "reactivate". We have discussed that UP is a normal bacteria in the genital tract and not known to cause NGU or urethral symptoms.

Based on all you say, I see no need to see a health professional. If you do so, a urologist may not be the best choice, although this depends on the individual doc and perhaps your location. In some countries (e.g. Japan), urologists tend to be the main STI experts. Elsewhere (e.g. the US), not so much. Are you maybe in the UK, where NSU is used more commonly than NGU? (Nongonococcal and "nonspecific" urethritis, i.e. NGU and NSU, are different words for the same condition.) If so, if you seek professional care at all, I strongly recommend a genitourinary medicine specialist -- perhaps at one of UK's excellent NHS GUM clinics.

Research has clearly shown that NGU (or NSU) does not cause urinary discomfort alone, without discharge. (Perhaps the best recent research on this was conducted by my forum colleague, Dr. Hook.) With neither discharge nor increased WBC, you can be sure you don't have it.

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