[Question #9246] Sex worker NGU risk

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35 months ago
A friend and I visited a massage club and a sex worker there gave my friend oral sex for a few minutes then gave me oral sex. Really   stupid. Two days later I felt  a cut sensation on the side of my penis.  I looked but could see no wound.  Before the week was out I began having urine issues frequency. Incomplete emptying.  No discharge of any kind just constant urge to pee. The cut sensation seemed to resolve. I checked with my friend and he was fine.  But got all the standard sti tests anyway.  All came back negative.  I read here that non chlamydia nGU can be contracted through oral sex.  But you say it’s not treated because it does not cause complications or infections.   But my symptoms have persisted now for three months and I am getting weak stream and smelly reddish urine.  My question is did I contract something. Either from the girl or worse from my friend?  He claims to be std free but was in her mouth for several minutes before she went down on me.  I read that stis if not treated can get into the prostate and cause long term issues.  I want to avoid that.  Thx doctors. 
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Edward W. Hook M.D.
35 months ago
Welcome to the Forum. Thanks for your question and the description of your problems.  Thanks as well for checking on other posts on our Forum for clues to your situation, that's precisely why we provide access to them.

As I understand it, at this time, your symptoms include urinary frequency and urgency, a weak urine stream, and malodorous reddish urine.  In addition, you were tested for STIs and had negative tests.  Do you know if the testing performed included a urinalysis, looking for other bacteria or white blood cells?   Your symptoms are not those associated with any STI, including non-chlamydial NGU.  They might be associated with a urinary tract infection or a prostate problem and the urinalysis would provide clues to this.  What I can assure you at this point however is, as you have already learned, with negative tests for STIs you are not a threat to the health of other partners.

This problem may be coincidental.  A urinalysis may provide clues.  EWH
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35 months ago
Thx doc. Had numerous urinalysis all negative for ecoli. But urinalysis is supposed to have very poor accuracy.  Some pcr testing showed no white blood cells. Other testing showed 4 wbc. Which some say means infection while others say it’s a normal urine result.  What do you say?  Could I get ecoli from oral sex?  The symptoms came on days after the oral encounter it seems highly suspect.  Also why is non chlamydia nGU not an issue here?  In some posts you say non chlamydia nGU should be treated and others you say it isn’t needed.   How can you be sure I don’t have non chlamydia nGU.  Thanks so much for your time!!’
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Edward W. Hook M.D.
35 months ago
Your rapidfire questions suggest that you remain anxious over the exposure you described. Your questions also suggest that you have been on the Internet looking for answers. Let me start this reply by urging you not to seek answers on the Internet. The Internet is not edited and there is no way for you to tell which information is accurate and which information is not. Much of what is found on the Internet is out of date, taken out of context, or just plain wrong. With that, responses to your specific questions:

1.  The presence of a few white blood cells in your urine is not a concern. Typically a urinalysis would detect large numbers of white blood cells and substantial numbers of bacteria if you were infected. Your negative result suggests that this is not the case.

2.  It would be most unusual to acquire E. coli from receipt of oral sex. In addition, E. coli are normally present in the genital tract of both men and women. Small amounts of E. coli in your urine would not be considered abnormal.

3.  With all due respect, the symptoms you describe simply are not symptoms which are at suggestive or in anyway typical of STI’s.

4.  Non-chlamydial NGU is not something we get upset about. There are no data to suggest that persons with non-chlamydial and NGU suffer complications nor are their infections transmitted to others. When persons are symptomatic with non-chlamydial NGU (which there is no evidence that you have) symptoms resolved quickly with anabiotic therapy. On the other hand the need for treatment in terms of prevention of complications, transmission, or public health importance is lacking.

Please don’t worry. EWH
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