[Question #942] Gonorrhea and Oral

50 months ago
I am in a monogamous relationship but made a couple of mistakes early last year (April - May). I had encounters with 2 CSWs which involved protected vaginal and receiving unprotected oral (on me). This past January a week after an encounter with my partner I noticed significant swelling in my right testicle. I went to the doctor and was prescribed antibiotics (no testing was done) which I finished even though the swelling was non-existent the next day. In April I got an std test, including urine for gonorrhea and chlamydia and all was negative. In that time, my wife also took antibiotics (not sure what) for a sinus infection. My partner has since started spotting between periods (maybe since March) and has substantially heavier period. I also had the right testicle swell in June and it went away in a couple of days without treatment. I'm really concerned that I caught something during the unprotected oral last year and passed it on to my partner.
50 months ago
Sorry, I should also note that no other symptoms have ever been noticed. No pain or discharge with the testicle swelling and no other symptoms have ever been communicated by my partner.
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago

Welcome to the Forum.,  I'll be pleased to comment but I can probably help you more if you can provide me with more information including what antibiotics you tool  when your doctor treated you earlier this year as well as what antibiotics your wife took.  The reason I ask is that some antibiotics work better of STIs than others.  It would have been nice of you had been tested when you saw your doctor as well. Have you been tested since that time?

Irrespective of what antibiotics you took, let me provide a little information regarding STIs acquired from receipt of oral sex.  STIs are relatively rarely acquired from receipt of oral sex (in comparison to STIs acquired through vaginal or rectal sex with a new partner.  If you did acquire an STI,The major concern in such situations is either gonorrhea or NGU (non-gonococcal urethritis) which can be caused by a variety of different, often difficult to test for bacteria.  Chlamydia can cause NGU but is rare in the throat and this is a rare complication of receipt of oral sex.  These problems are usually symptomatic, leading to either burning on urination or an obvious penile discharge.  Testicular swelling would be quite uncommon and episodic testicular swelling of the sort you describe in not suggestive of any STI.

In addition, you wife's spotting and recent heavier period are non-specific findings which can occasionally be associated with STIs but could also be caused by any number of other non-STI processes as well.

I may have other comments when I hear your reply to my questions above.  EWH


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50 months ago
I don't recall the antibiotics used other than reading that the one prescribed to me is typically used for sti's. I was tested only the once at the end of April and all was negative (this was a few months after my antibiotic dose and with regular relations with my wife in that time with no symptoms on my part) Since my last risky encounter was 8-9 months prior to my symptoms and 11-12 months prior to my wife's im assuming that my risk is low but your opinion is greatly appreciated.
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago
A agree, your risk is quite low.  I understand your apprehensions but with negative tests since your possible exposure, I would recommend that you move forward with confidence that neither your scrotal swellings nor you wife's recent spotting and heavy period are related to the exposure you described.  From what you tell me, I see no medical reason for further concern or testing.  EWH
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50 months ago
Thank you so much for your help.
50 months ago
I just wanted to clarify on the testicular swelling. The first time I had it, back in January, it had come on quickly and my right testicle was about twice the size of the left. I went to the doctor but by the time I was in to see him, about 6 hours later, it was already considerably smaller. He did ultrasound and said possibly epididymitis. I had no pain, no discharge, and it had been about 2 weeks since my last sexual encounter with my partner. It was gone within a day or two. The next incident was a few days after having sex with my partner. I couldn't get to a doctor and it went away on its own within a couple of days (again no pain or discharge). I'm 36 and have had a vasectomy. Are there other conditions that could cause this painless swelling? I guess my overall concern was that I caught something asymptomaticall last spring, gave it to my wife, then got it back with this swelling as the only symptom. Then got rid of it with antibiotics (neg. urine test in April) and caught it again with swelling as only symptom again.
Edward W. Hook M.D.
Edward W. Hook M.D.
50 months ago
Although the doctor who saw you had the advantage of being able to examine you, what you describe does not sound like epididymitis.  Typically the swelling of epididymitis neither appears nor resolves quickly in the way that you describe.  Further the sort of recurrence you describe does not match up either.  What you describe sounds very much like a cystic process such as a varicocele or other cystic problem, perhaps related to your vasectomy.  I would suggest you discuss it with a urologist.

Nothing in your story suggests that this is an STI related process.

I hope this comment helps.  As this is my third reply, this thread will be closed in a few hours.  EWH
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