Infections After Unprotected Oral Sex: A Urology Perspective

Q: Infections After Unprotected Oral Sex: A Urology Perspective

Hello： Some infections may be easy to identify, but the specific type of infection can be difficult to diagnose. <br>The medications you are using are aimed at treating the infection, and theoretically, they should effectively resolve it. <br>If you have not engaged in sexual act

Infection after unprotected oral sex?

Hello Doctor, I previously asked you some questions, and I have some follow-up issues regarding my examination.
Let me briefly describe the complete situation: 12 weeks ago, I had an encounter with a sex worker, during which I received unprotected oral sex and had protected vaginal intercourse.
That night, when I got home and took a shower, I noticed some pain in my testicles.
After two weeks of experiencing intermittent testicular pain, similar to the sensation of cold weather affecting the testicles, I also had occasional sharp pain and warmth in my urethra.
Therefore, I visited a urologist who, after the consultation, indicated that I had an infection but did not specify what it was or conduct any tests.
He prescribed three doses of Colchicine to be taken over three days.
Upon my follow-up visit, since I still felt pain, the doctor prescribed Doxycycline 250 mg, instructing me to take four tablets the first day and two tablets on the fifth day.
He also prescribed another antibiotic to be taken three times a day.
During my follow-up, I mentioned that I had previously injured my lower back, which had been causing soreness for over a month, and I had also recently experienced soreness near my hip.
I noticed that the testicular pain seemed to coincide with the lower back soreness.
The doctor explained that this was likely interconnected, suggesting that the urethral discomfort might be due to an infection, while the testicular pain was a secondary effect.
He concluded that there was nothing serious and advised me to see an orthopedic or rehabilitation specialist.
In the sixth week, I underwent a sexually transmitted infection DNA test, which returned negative results.
The testing personnel explained that DNA testing detects viruses, not antibodies, so the window period is shorter.
However, due to my concerns, I decided to get tested again after 12 weeks at a different laboratory, where I tested positive for Chlamydia antibodies.
The laboratory staff indicated a titer of 1:64 positive but 1:128 negative, suggesting that I had previously been infected but had since recovered.
Could you please clarify if this means I indeed had a Chlamydia infection before, but it was treated while I was on the medication prescribed by the urologist? Additionally, I have not engaged in sexual activity with my partner during these 12 weeks; is there a possibility that I could transmit the infection to her?

Lao K, 30~39 year old female. Ask Date: 2020/04/24

Dr. Du Shixi reply Urology

Hello: Some infections may be easy to identify, but the specific type of infection can be difficult to diagnose.
The medications you are using are aimed at treating the infection, and theoretically, they should effectively resolve it.
If you have not engaged in sexual activity after the infection, it should not be transmissible.
Wishing you good health.

Reply Date: 2020/04/24

More Info

When it comes to understanding the risks of infections after engaging in unprotected oral sex, particularly in the context of your experience, there are several important factors to consider.
Firstly, it is essential to recognize that oral sex, especially when performed without a barrier, can carry risks for sexually transmitted infections (STIs), including HIV, gonorrhea, chlamydia, syphilis, and herpes. The risk of transmission varies depending on the specific infection and the presence of any cuts or sores in the mouth or on the genitals. In your case, you mentioned having unprotected oral sex with a sex worker, which does increase your risk for STIs.
The symptoms you experienced, such as testicular pain and urethral discomfort, could be indicative of an infection, but they are not specific to any one STI. It is worth noting that testicular pain can sometimes be referred from other areas, such as the lower back or pelvis, especially if there is an underlying issue like a muscle strain or nerve irritation. The fact that your symptoms persisted despite treatment suggests that further evaluation may be necessary.

Regarding your concern about the Chlamydia test results, a positive antibody test for Chlamydia (1:64) indicates that you have been exposed to the bacteria at some point, but it does not necessarily confirm an active infection at the time of testing. The negative result at 1:128 suggests that the infection may have resolved, especially if you were treated with antibiotics prior to the test. It is also important to note that antibody tests can remain positive for some time after an infection has cleared, so it is possible that you had a past infection that has since been treated successfully.

As for the risk of transmitting any potential infection to a partner, if you have not engaged in sexual activity since your treatment and your symptoms have resolved, the likelihood of transmission is significantly reduced. However, it is always advisable to communicate openly with your partner about your sexual health and to consider getting tested together for peace of mind.

In terms of follow-up care, it is crucial to continue monitoring your health. If you experience any new symptoms or if your previous symptoms return, seeking further medical evaluation is warranted. Regular STI screenings are recommended for sexually active individuals, especially those with multiple partners or those who engage in high-risk behaviors. The Centers for Disease Control and Prevention (CDC) recommends that sexually active individuals get tested for STIs at least once a year, or more frequently based on their risk factors.

In conclusion, while your past experiences may have raised concerns about potential infections, the steps you have taken to seek medical advice and testing are commendable. It is essential to maintain open communication with healthcare providers and partners regarding sexual health, and to continue regular screenings to ensure ongoing health and safety. If you have any lingering concerns or symptoms, do not hesitate to reach out to a healthcare professional for further evaluation and guidance.

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