[Question #2116] Std concern

45 months ago
Hello Doctors,

Well I have finally talked myself out of my HIV concerns due to my most recent encounter (frottage, unprotected oral, protected anal with a Trans CSW). However, about 27 days post encounter I awoke with a unspecified pain in my foreskin that I could not found any corresponding lesions, sores, etc to explain the cause of. Also, know anytime I ejaculate there seems to be irritation of the urethra afterwards. Also, there will also be multiple red spots on the foreskin which appear to be red and raw afterwards as well. I am now sitting at about 40 days post encounter. There have been no obvious sores, blister lesions, etc. I also took a oraquick test at 38 days which was firmly negative. Do you have anything that could explain these symptoms. I am extremely concerned as I will be headed back to my spouse next week and I would not only like to have pain free relations, I would also like to not pass anything to her as well. Please any advise on what this could be would be awesome. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Welcome back. But sorry to see you remain concerned, this time about STDs other than HIV.

There are no STDs that cause skin pain -- of the penis or anywhere else -- without visible ulcers, blisters, or other obvious lesions. Red spots under the foreskin are extremely common, enough to be considered normal. Improved hygiene (retracting the foreskin and washing with soap and water once or twice daily) probably would take care of it. I'm fairly sure you're simply more sensitive to minor symptoms, or even normal body sensations and skin appearances, that you would ignore or not even notice, except for your anxieties over a sexual decision you regret.

In summary, there is nothing in your symptoms or exposure that make me concerned that you have any STD, or any condition that could harm your wife when you resume sexual relations with her. 

I hope this has helped, but let me know if anything isn't clear.

HHH, MD

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45 months ago
Thanks again for the quick reply. I have seen advice similar to your elsewhere as well in regards to hygiene. My only issue with this is that it always seems to be directed at uncircumcised individuals, however the last I checked I've been snipped for close to 30 years. I have had issues with balantis in the past, but it was always accompanied by painful cracks and peeling skin, which don't seem to be evident this time. Also some of the red spots are in the same area as the pearly papules that people often discuss which become irritated after masturbation as well.

I am just attempting to paint a full picture for you, however if none of this changes your answer feel free to  not respond.

Thanks again for what you do.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Indeed, red spots or balanitis are primarily problems in uncircumcised men; I assumed that included you. Sorry. In any case, there are no STDs that cause "red spots" that are painless, persist for more than a couple of days, and do not change appearance over a day or two. My guess is you are noticing normal anatomic variations of your penile skin. But if you are convinced they are new or abnormal, see a doctor. But whatever they are, I am confident they are not an STD. On my bookshelf, 2 feet from my desk as I type this, is a book titled Genital Dermatology Atlas. As the name implies, it is filled with photos of skin conditions of the genital area. Of the book's 300 pages, only 15 are on STDs. In other words, the vast majority of genital skin problems are due to thing other than STD.

Thanks for the thanks. That's why we're here!

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45 months ago
So basically what you're telling me is, "don't think zebra when you hear hoof beats." Ok I may still go get testing when I get back to the states, but you seem to think that it would probably be a waste of time at this point. 

Also, am sure that book is quite the page turner lol.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Yes, that's more or less it. Based on all you've said, it it were me I wouldn't be tested and would be looking forward to resuming sex with my wife on returning home, without worry for her health.

Cheers--  HHH, MD

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