[Question #2488] unprotected Oral sex and now frequent urination/ tingling on penis?STD or Mental

44 months ago
Had drunk uprotected oral sex on 5/8/ in the Caribean and Protected Vaginal Sex (with a prostitute). Married with kids. 3 hours later I started urinating frequently. Next day I felt a warmth in the genitals / left side of penis shaft (circumcised) also / need to urinate all the time / tingling. I feel like I still have to  pee a bit even right after urinating. Went straight to the doctor on 5/10 and took  full blood and urine tests for STD's.  All came back clean (even for UTI) except for HSV 1 had an IGG count of 6 which is from prior. Have had cold sores in my mouth as long as I can remember. Doctor gave me Doxycycline to diagnose wile we waited for the results. The urologist gave me bactrim which   significantly upped the heat / warmth and caused skin dryness on genitals. 

6/12 - 4 weeks after- I took a full set of tests. HSV1 - high count of 38.9 -HSV2  came in a low positive of 1.89. Doctor said it could be a false positive and to go to an internist. Although the warmth and urination had semi stopped for a couple days prior to this, upon getting the results it came back full fold. 

6/16 - (5.5 weeks) post exposure  - took another test only for hsv2 which came back negative. 

6/22 - (6.5 weeks)  I followed up this test with a Western Blot -  Negative for HSV2. Positive for HSV1. But still concerned, I read the blot may not be accurate until after 12 weeks. 

Been feeling the warmth on genitals and shaft since June 12th, along with the tingling (if you can call it that) on left side of shaft and need to urinate. I can hold it but its  always there. When  I'm more busy its not as evident. When am sitting / working its more prominent. I have had no other symptoms. No lesions, no ulcers/ pimples. 
Is it possible I contracted HSV1 genitally or perhaps in the urethra even though I alredy had it? Does hsv1 cause a warmth in the genitals and frequent need to urinate and would it hold out this long without subsiding? OR do you think this is prostatitis from stress?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
I am not particularly concerned about the warmth feeling - that is not normally associated with herpes.
Have you actually had a sore on your lip on in your nose or only IN your mouth?  the sores in the mouth are usually canker sores which are unrelated to herpes.  without an exam, I would have no idea of you might be experiencing prostatitis.  Also, herpes symptoms are intermittent, they are not constant as your "warmth" is. 
Having said all of that, you did obtain the western blot very early in the course of things - I ask that patients wait 12 weeks at a minimum after an exposure.

Terri
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44 months ago
I have only experienced sores in my mouth.  However if  I didnt have Hsv1, would it show in the IGG test 2 days after the potential exposure? How can I confirm if I the mouth sores are herpes?  Get a swab when I get the next one?

What do you recommened I do to further treat or diagnose?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
It appears that you were infected with HSV 1 well before the encounter. 
You could get a swab test of the mouth lesions when you get the next one, yes. 
Your antibody test simply tells you that you were infected with HSV 1 prior to this encounter - it does not tell you where you infection is located.  We cannot know if you have HSV 1 genitally or orally.

Terri
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44 months ago
I am aware. Since I'm pretty sure I had HSV1 prior and orally since Ive never had genital symptoms,  and HSV2 is negative, is there a chance these symptom are HSV1 in genitals? If not , what steps should i take to see what they are. If they are stress who do  I speak with? Do I need anti-iflamatories?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
Yes, your antibody test indicates that you were most certainly infected with HSV 1 prior to this encounter since you tested positive for substantial antibody two days after the encounter.  There is always a chance you have this genitally if you have received oral sex in  your lifetime, other than this event.  If the warmth feeling is really troubling for you, you could see a urologist again.  From your post it appears that the antibiotics increased the warmth sensation rather than decreased it so you should let them know that. You could try re-interpretting the warmth feeling as pleasant rather than dangerous.  You said you've had the full battery of tests so you can be reassured it is not an STI.

Terri
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