I met a guy and gave him a hand job. I then masturbated myself with the same hand that I masturbated him with. His scrotum had 2 pimples that were far apart from each other (maybe 2 inches far apart) on the front part of the scrotum. I did not touch it. As I am uncertain that they were pimples, I am concerned that I have gave myself genital herpes. 2 days after the encounter I felt: Muscle twitching in the quads, thighs, buttocks, calves. Scrotum tingling – between 5 – 15 times per day lasting for 5 seconds each. Other symptoms felt occasionally (i.e. few times only) over 35 days: Sharpish pain in the pubic area (next to the base of penis). Throbbing sensation inside the scrotum. Pain inside penis head. My concern is that I never felt scrotum tingling (and other symptoms) in my whole entire life. However, 2/3 days after the encounter I feel them! The timing of it suggests herpes to me, and I didn’t even feel anxious about the encounter (only minimal guilt). My questions are (Note: I have zero lesions whatsoever): Can herpes cause scrotum tingling? It has been 35 days now, and I still feel it! Can herpes cause occasional throbbing inside scrotum, sharpish pain in pubic area, slight pain inside penis head? Can herpes cause prodrome symptoms for 35 days? Someone mentioned I could have herpes, but my immune system is fighting it, hence no outbreak. How possible is this? Can a primary herpes infection cause tingling? Can these symptoms really be psychological? 

Hello Dr Hook,

I have spoke to a urologist online who suggests that I may have pudendal neuralgia (no examination or anything was done). I have read your comments and have understood that herpes cannot cause symptoms etc. However, I was just wondering if pudendal neuralgia is a rare complication of herpes that has a different manifestation and therefore can cause all of my symptoms? Or does the same principle apply that pudendal neuralgia cannot happen in the absence of lesions? Are pudendal neuralgia and herpes even related at all? I have no medical knowledge on pudendal neuralgia. 1) I forgot to mention that I gave a blowjob before giving a hand job and then masturbating myself with the same hand. Does this (my saliva) increase the risk of transferring HSV from his genitals to my hand to my genitals or is the risk still nil? I am guessing the risk is still nil but thought to double check with an expert like yourself since I forgot to mention a large aspect. I have been tested for oral stds and they are negative. 2) I have come to understand that a primary herpes infection usually occurs where the virus was rubbed in. Since I didn’t even touch my scrotum during the sexual encounter, is this further proof that primary herpes cannot be the cause of my scrotum tingling (prodrome has already been excluded due to the bilateral nature of symptoms).

I would like to thank you deeply for the assessment you have provided me. Thank you for the hard work and contribution you have made to the field! You have helped me psychologically enormously and I really appreciate your input. I would have been so lost without your expertise. Thank you again!