[Question #10496] One more question with reference to question 10429

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22 months ago
Hello dr, it’s me again just with one last question for you. I have followed your advice from previous thread and am going to be seeing a urologist when I come home from this current work stint( in a remote area)  but in the mean time I’m still having some anxiety over the lingering symptoms of burning penis head. 

I’ve read online that herpes can cause urethritis and am hoping that isn’t what I’m dealing with after my negative chlam and gon  test twice and normal urinalysis. I’m From an area in Canada  where they don’t do blood tests for HSV. Only swabs 

My questions are 


1) does Herpetic urethritis mean herpes sores are directly inside your urethra which you’d probably notice?  and from what I’ve read if it was the case it would make urinating excruciating, and would also likely cause visible sores as well

2) is there any chance that with the fact that I’ve never had any symptoms of herpes sores around my genital  area that this on and off penis burning head and sometimes slight testicle pain and 2-3 episodes of discharge  I     Experienced years back could have  been herpes urethritis? When it first started the burning penis head and dull testicle ache didn’t subside for months, that doesn’t sound consistent with herpes, right? And since then it only comes and goes periodically and I never have any visible lesions. The burning feeling always goes away when I ejaculate. Is it safe to say this is not herpes related?  
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Edward W. Hook M.D.
22 months ago
Welcome back to the Forum and thanks for your questions.  On this occasion I happened to pick up your question.  In preparing to respond I did review your earlier interaction with Dr. Handsfield and agree with all that he said.  I’ll go straight to your questions and then follow up with another comment or two.  

1.  Herpes urethritis is often accompanied with external herpes lesions.  More importantly however, the long duration of your symptoms as well as their waxing and waning without other problems rules HSV out as a cause of your symptoms.

2.  The description you describe is not at all suggestive of herpes.

I’m pleased that you will be seeing a urologist.  I’m confident that your symptoms are not due to an STI and favor prostatitis as the cause.  EWH 
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22 months ago
Thanks doctor for your quick response! That is greatly reassuring and you have helped calm my anxiety and for that I thank you. 

One last question - when I think back there has been times over the years.. particularly after sweating playing sports or working that I did notice a small red spot on the shaft of my penis which wasn’t raised or didn’t contain fluid or blister or ulcer or anything and it always was gone within a day or two. I’m assuming there’s no possible way it was herpes  given those facts? 
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Edward W. Hook M.D.
22 months ago
There is no way in retrospect to comment on whether an otherwise unexplained red spot on your penis was HSV or not however, the scenario you describe certainly does not sound like typical HSV recurrence.  I would add however that the I am confident that the spots you describe are not related to the discomfort you've experienced at the head of your penis.  EWH---
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22 months ago
Thanks again doctor, when I think  back it was literally just a single small red dot on my shaft that looked like nothing more than maybe a clogged sweat gland - and it disappeared  usually within a day - maybe 2 or 3 times. From what I understand  herpes usually presents as a cluster of water like blisters   that are tender and go through several stages from bump to blister to open ulcer before scabbing over and falling off, correct? Meaning what I am describing sounds very benign and not herpetic whatsoever?  
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22 months ago
Sorry, I didn’t mean to say clogged sweat gland. It didn’t look anything like a pimple of any sort or anything it just looked like a small red spot that was totally flush with my skin like a minor irritation. And it was gone with inn a day like I said, sorry that will be my last post here 
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22 months ago
Sorry, you don’t have to respond to this last question. I should have ended it at the last one with what you told me didn’t sound like HSV. My apologies, that will be all from me and thank you again for your advice and kind words!
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Edward W. Hook M.D.
22 months ago
Thanks.  The additional information does not change my assessment.  EWH ---