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Encounter with masseuse and pain on urination

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I believe my query needs to go to ID Specialist - Infectious disease specialist, please..

I’m 32 yrs old male. I encountered an accident with a masseuse/prostitute on 3 May. She had done the normal massage all over the body, then something unplanned happened, she licked my anus, gave me oral sex- unprotected. We then had sex for 5 min but that was with condom.

In about 3-4 days, I was starting to feel pain when urinating, burning sensation etc. somewhat whitish surface on top surface of penis, had unwanted smell on that surface area - no fluid discharge or blood though. I just relied on drinking plenty of water, lots of cranberry juice and did not see GP for about a 10 days. I realized that I might have some sort of infection as pain did not go away and then saw GP finally. She asked for urine test, STD blood test, ultrasound for kidney etc.. and gave me some sort of antibiotics for UTI. Reported attached. No STD infection was found. Kidney ultrasound report looked normal. My major complaint about pain did go away, however I still had some sort of strange tingling and somewhat urine burning feeling. My GP said, things are normal and it is just in my brain, but I still preferred to see a Urologist as I’d a strong feeling that something is not seeming right. And lucky that I saw him.

Urologist physically examined me, 21 June, he suggested, I had some swelling in my prostate grand, he prescribed me Ciprosloxacin 500Mg 14 QTY (2 times/7 days)
I did then felt normal and all remaining complaints, pain in urinating, was gone. I was asked to do urine test 7-10 days following the completion of my medicine, it came normal.
26 July, I saw him, he pointed, the Leucocytes got reduced down to 1 from 8 – in two urine tests that I’d done by this time, which he said is a good thing. He declared, I’m all good, also I’m safe to have sex with my wife. So this is the background…

From about June, I also had a strange tingling feeling in my anus, bit hard to describe but it catches my attention few times in a day. It is not going terrible but I feel like, never ever in my life it caught up my attention at anus. No itchiness, no pain, no burning, no blood evidence in tissue, I can feel skin appears to be normal, but feels like a worm coming out or something. I know it’s not worm but kind of tingling sensation. At early stage in June, I’d thought it’s all related, so I did not mention to Urologist. But on 26th July, I mentioned him about this, he said, he can’t think of anything else, I’m all good.

I let time go, no change in this anus sensation, I saw him again, 4 Nov, his response stays the same.

The other thing is, I have a chronic sinus condition from many years, but in general sinus problem was ok up until, May. From about mid May, I noticed that I seem to continue get post nasal drip (sticky cough, sometimes yellow but generally white) and may be my sinuses are inflamed I think. I observe pain surrounding my eyes. I do have blockage in left frontal sinus from 2 yrs but despite, I did not have post nasal drip before May. I suspect that I’m still somewhat infected, somewhere, it’s just hasn’t been diagnosed properly. When I had flu or viral infection in winter season in past, that is when I used to get post nasal drip. This also makes me feel, some bacteria is still in my body because of this exposure.

I don’t have discharge, no marks on penis, no burning pain when urinating but I observed, these days, if I wipe penis tip after urinating, it doesn’t smell so good. I still have a feeling that I might still have some sort of dormant or active bacteria in my body. Per my Urologist, it is just body’s natural bacteria smell, so nothing to worry. Per him, it got to be like a fish smell, with a discharge, etc., which I’m not experiencing so he reckons I don’t need to worry about, and I’m good. But I don’t recall even such smell before the exposure.

From 26th July onwards, since Urologist gave me ok, I’ve been having sex with my wife and we don’t use condoms. Beginning Oct, my wife reported, she has been having pain above waist, very bad pain which lasted few days, she then did ultrasound for kidney and urine test per GP but it came normal. No possibility of kidney stone. She experienced warm body for few days, but wasn’t warm enough to be considered as fever. GP said, she is all ok. Currently, she is sort of ok but sometimes I can feel her body warm. Since there was no evidence in her urine, GP didn’t prescribe anything. I don’t know if this means anything to you? Any hint etc.?

Note: I experienced warm body in first week of May following exposure but these days, I don’t feel warm and also no fever. No headache, no pain in throat.
Based on my blood reports of 26 July, my GP suggested to take 3 injections of Hepatitis B vaccination (20mcg), I’ve already completed 2 so far, next one is due in few months.
I’ve repeated HIV 3 times, all negative. Last test was 31 Oct.
I've attached all reports that I've done so far.

My questions are:

1. How do I find out I’m not still infected in any way with this exposure? What tests can I do? Is there anything should I repeat? What if any blood or urine tests you suggest comes normal? My GP and Urologist suggests that I’ve already had STD tests and they don’t think need of repeating it.
2. That strange tingling anus feeling, kind of bacterial smell on tissue after wiping the penis tip and my post nasal drip in sinus gives me warming signs, I feel, I should not keep ignoring this and do some tests. Basically eliminate any possibilities of any kind of infection present in body. Please suggest me, how do I eliminate this?
3. If I have any kind of STDs then shouldn’t I get fever? I don’t get fever.
4. I haven’t told my wife about my exposure, so I’m reluctant to tell her doing any STD tests. I feel, if all of my tests comes negative then how come she can get infection from me?
5. In next 3 months, we are also planning for a baby but I wanted to get back to my normal life and get well first. If any precautions that I need to take at this stage before we plan – Ie, doing specific blood test, urine test etc. either for me or for my wife then please advise.

Thanks !

Category: Infectious Disease Specialist

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Category: HIV- AIDS Specialist
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Consult reply with inputs from Dr. Kruti Jobanputra Banodkar (


Thank you for asking your query at DoctorSpring.
First of all the sexual encounter you has is of not high risk type, since you used condoms. Chances are that your symptoms are not related to STDs at all.

Let me list down my opinion for clarity.

1. You will need to do a test for Herpes (Antibody Test) and a standard serology test for Syphilis in addition to the tests already done.
1. If the anal symptoms persist a physical examination needs to be done to rule out any lesion. Enterobious worm infection can also cause the symptoms. If the symptoms persists you can take an anti worm tablet like Albendazole in consult with your Doctor. Prostatitis needs considered if all tests are negative and symptoms persist.
3. The sinus symptoms are unrelated and are probably in allergic in origin.

To answer your specific questions:

1.Most likely there is no infection. Please do the above mentioned tests in addition.
2. The sinus symptoms are unrelated. Please get an HSV(Herpes) and Syphilis test done. You can also go for a CRP and ESR. (High values may denote infection – but not specific). Prostatitis needs considered if all tests are negative and symptoms persist.
3. No, fever is not a rule. You can get STD without fever
4. Your wife’s symptoms are NOT suggestive of any infectious disease. So please do not worry about that. You may want to check her Thyroid hormone levels
5. Please do the above mentioned tests. If they are also negative you can go ahead with your plans in consult with your Doctor.

Hope this helps
Thank you

Patient replied :

Hello Doctor,

Thanks for your response.

Few more things I have to ask you please,

1. Is that okay not to use condom during sexual intercourse with my wife just now or should I use it until I get results back from Herpes (Antibody Test) and a standard serology test for Syphilis? In fact, I'm not using condom from past few months since Urologist gave me ok that I'm all good. I’m little bit concerned now.

2. If I get positive towards Herpes or Syphilis then should I also then check my wife for it too? As chances are I might have infected her too, make sense?

3. You've indicated Prostatitis needs to be considered if all tests are negative. Who should I see to discuss that? ID specialist? I’ll need referral from my GP to see a specialist, what should I tell GP? Can I see the same Urologist to discuss this or this is not the subject of Urologist at all? Since my Urologist is also familiar with my background now, it will be easy for me to explain him but not sure if he can diagnose this ?

4. Are there any specific blood tests or urine test or other test to help diagnose Prostatitis? Please suggest so that I can tell to my Urologist to do for my peace of mind otherwise he may say I’m all good and send me back home.

5. If I rule out Herpes and Syphilis and both tests comes negative. And while I’m following up on the findings of Prostatitis, what precautions I should take with my relation to my wife? Is that ok to have sex without condom? should we also wait for baby planning until I sort out Prostatitis?

thank you very much !

1. You need not use condom, especially since you were not using it for sometime.
2. There is a chance that you might have infected her. However she needs to be tested only if you have a positive Syphilis test. (as herpes need no specific treatment). However if she has any symptoms it should be evaluated separately. Most likely those are unrelated to your sexual encounter.
3.You should discuss this with your Urologist.
4. A prostatic fluid culture (after a prostate massage) can be done. However this is better done after a clinical evaluation.
5. First of all you need not followup on Prostatitis. If Herpes and Syphilis is negative and by the time if your symptoms are absent, you should relax and take it easy ! Rather than fixing on prostatitis, it will be better to do a general reevaluation. So you need not wait for sex with your wife. And your baby plans can go on , unless there is any major troubling symptom.

Hope this helps
Please feel free to ask followups
Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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