I have been following this site for past 2 weeks. I had a similar exposure like most people did. Protected vaginal and unprotected oral sex. I was given oral sex by a girl who claims to be STD free. It's been 5 weeks. I got tested for gon/chlam/ trip at 5th day after my exposure which came back negative. But today which is 5 weeks from exposure I started having burning urination and little burning in butt crack while taking dump. I checked for any lessions on my penis but found none. The burning is Mostly on my penis head and it all started after I masturbated with just two fingers ( thumb and index finger sliding them only on the penis head).  And I cleaned my penis is a soap. 

Are these symptoms of any STD? Previously I was negative for all STDs ( including herpes 1).  Should I be worried about any STDs and do you recommend testing now? Also I feel like something is in urethra at base of penis head. And I get slight pain when my urine is passing through that spot. Could all this be related to masturbatuon? Please help me. Thanks

The direct answer to your specific question is no:  these symptoms are not typical for any STD. Although painful urination can be an STD symptom, it's rarely a symptom by itself; usually there would also be abnormal discharge of pus or mucus. Further, any STD causing this symptom would appear within 10 days, not 5 weeks later. No STD caught by exposure of the penis can cause anal irritation or burning. Finally, your negative testing at 5 days after exposure is very strong evidence against gonorrhea or chlamydia, the main potential causes of such symptoms.

Turning to herpes, the feeling of pain at a particular spot inside the penis could be due to herpes. However, several aspects argue against it:  no external blisters or sores; first symptoms several weeks after exposure (usually within 3-5 days); and herpes in the urethra usually is a lot more painful than you describe. (I have had patients who described it as the worst pain they ever experienced.)

As for other causes, you obviously have your own suspicion about the masturbation event. Certainly vigorous contact could cause the sorts of penile discomfort (but not anal). Perhaps pertinent, soap is very irritating to the urethra -- if any got inside, that's a good bet for pain the next couple of urinations.

I suggest you give it 2-3 days. If any of these symptoms are continuing at that time, it would be reasonable to see a doctor. However, I doubt they have anything at all to do with the sexual exposure 5 weeks ago.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

1. What are my chances of hiv with my exposure? And I will get tested at 6 weeks mark with 4th Gen test just to ease my mind. Will it be conclusive at 6 weeks?

2. What are my chances of herpes with my exposure? And when is the best time to get tested? 6 weeks or 12 weeks. Given that she had no sores or lessions during our encounter and I had no symptoms till yesterday ( which is 5 weeks)

3. What are my chances of HPV? Can oral sex cause hpv if so how common is it? What are the symptoms I need to look for.

4. I think my urethra is inflammated due madturbation and/or due to soap. What should I do to ease that? Apply ice? Or any OTC medication. I am having pain on and off. Not every urination is causing me pain. I have been drinking lots of water. Mostly morning (first one to one till noon) is giving me discomfort. And on a scale of 10, it is probably 4-5. And my penis tip is feeling like it's on fire from today morning.

2) No more than 1 chance in several thousand for either HSV1 or HSV2. But see no. 4 below.

3) There are no data on which to base a numerical estimate of risk from either the oral or protected vaginal exposure. Undoubtedly low, but in any case you already have had HPV and will get it again. Everybody gets it, several times. With rare exceptions, no single exposure ever significantly raises the risk over what it was before the exposure.

4) As implied above, I would have expected this symptom to clear up within a couple of urinations. Since it apparently has not, I have no other advice beyond what I said above, i.e. see a doctor if it continues. As I also said above, it is conceivable that herpes could do this. If that's what you have, it's an atypical case, and probably is actually a recurrent outbreak (with your initial infection being asymptomatic). It would be best to see a doctor familiar with STDs and make sure a urethral swab is collected for herpes PCR (not culture -- request PCR). For all the reasons already discussed, I doubt you have herpes -- but based on your symptoms, I cannot rule it out.

You have one more follow-up question coming on this thread. I suggest holding off on additional comments questions until you have been examined have a professional opinion about this problem. Good luck!

Actually my pain has gone down a lot. I barely feel it. Maybe because I started drinking lots of water. Also I think I got it wrong. I dont feel like something is blocking in my penis head. Its most likely a mild pain/burning.  If it is herpes, wont the pain be constant irrespective of passing urine or not? Anyway I will get tested at 6 weeks. What is the accuracy at 6 weeks?

Obviously I agree with the doctor about the usual severity of urethral herpes. See my initial reply, paragraph 3. But I also said there are exceptions -- yesterday's reply, including my comment "it is conceivable that herpes could do this". Had you been my patient, I probably would have done a PCR test for HSV. But it might have been too late anyway, since your symptoms were improving. At this point, if you want to pursue possible herpes, it may require blood testing. But I still think herpes is unlikely, for the reasons discussed above.

A standard urine culture will detect a non-STD bacterial urinary tract infection (UTI), but not any STD.

At one time, it was thought that cranberry juice and other cranberry products could help protect women against bacterial UTI. More recent research shows it does not. Either way, cranberry is not known to have any effect on urinary symptoms and I would attribute any improvement to placebo effect.

You are free to ask yet another question if you would like. When you first posted this one, it wasn't clear that your main concern is herpes. If you post another, it will be answered by Terri Warren, our herpes expert. It's up to you. But my guess is she will pretty much agree with all I have said.

hello doctor, sorry to bother you.  i want to explain my symptoms for the past 3 days

Next day after masturbation:

Day 1: Started having burning urination. And my penis head was burning constanlty through out the day

Day 2: Burning has reduced a bit.

Day 3 (today): Last night applied ice on penis for 15 mins. Skipped breakfast today (after a long time). Was on empty stomach for half day. Drank only water and cranberry juice. As soon as I drank cranberry juice on empty stomach loose stool has started and its through out the day but burning was almost gone

I noticed an increase in dribbling after I urinate and it feels like there is constantly some type of liquid sitting inside of my urethra just waiting to drip out and does occassionly.

Can NSU recur? i was treated for NSU with doxy when my tests came back negative for gon/chlam//tric. now i am havng similar symptoms

These symptoms are not consistent with any STD. Masturbation is no risk, and "next day" is too soon; no STD can start to cause symptoms that soon.

Nongonococcal urethritis (NGU, same as NSU) indeed can recur. However, the main symptom of NGU is discharge. Uncomfortable urination or urinary dribbling usually are not due to NGU or any other STD.

Normally threads are closed after two follow-up question or after a month, whichever comes first (indeed, the reason I found this message was that I was planning to close the thread). However, I'll leave this open a few more days in case you have more to add following these comments. Apologies again for the long delay.