[Question #2977] NGU / Urethitis / Herpes?!
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93 months ago
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Ok, so I'm asking this question with the details from my initial question (#1507). Long story short, had two encounters - both involved unprotected oral, and in one of the instances a brief few moments of unprotected insertive anal (this was on 8/1/16, the other on 8/8/16 was protected anal). Ended up getting Chlamydia which I had passed on to my wife which is what led me to take a full series of tests (HIV, herpes, syphilis, gonorrhea. chlamydia) on 8/30/16 all of which were negative sans the chlamydia. We were both treated for chlamydia with 1g azithromycin and my wife's further tests showed it was cured. This brings me to today. I have been completely faithful to her ever since those incidents having unprotected sex and over the last few days, I've noticed a mild sensation in what feels like my urethra/tip of the penis. Nothing is red, irritated, or otherwise bothered - but I still notice this feeling, but don't have any issues with urination. I'm trying to figure out if this mild burning-like sensation could be NGU or urethitis, but I'm panicked over this being herpes. In the 15 months since that encounter neither me or my wife have had anything even remotely related to herpes symptoms - no sores/blisters/red spots/itching/burning anywhere on my penis or genital area - but read online that in rare cases, NGU/urethitis could be caused by herpes which would be very painful and be accompanied by lesions. Am I overthinking this? Could this possibly be herpes? Trying my best to be logical but anxiety is driving me nuts... please help!
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Edward W. Hook M.D.
93 months ago
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Welcome back to the Forum. I understand how doubts can persist and want to begin this reply by stating that, as long as you and your partner have been mutually monogamous, the sensation you are experiencing is NOT associated with your misstep nearly a year and a half ago (other than perhaps a lingering, persistent concern and guilt). Having said that, let's address your concerns.
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Could this be NGU and if so, could it be related to an STI? As it turns out, in over half of NGU no STI can be found. Current thoughts are that this sort of NGU comes from when a sex partner's normal bacteria (from the genital tract, rectum, or mouth) are introduced in the male penis during sex. This sort of NGU can go away by itself and does not appear to pose a threat to sex partners. Perhaps this is what you are experiencing. Alternatively, what this could be be may be simply height Ned awareness of normal, perhaps self limited sensations which you happen d to notice.
What this is not, is herpes urethritis which, as you point out is typically Guiterman uncomfortable and is usually but not always associated with lesions. Further, you mention above that you were tested and negative for HSV. I presume this was a blood test. M while the blood tests are not perfect, in the situatiOn you describe, with mutual monogamy and negative tests you can be confident that this is not herpes.
I hope these comments are helpful. If you really want to see if this is NGU you will need to see a health care provider who can test your penile secretions for inflammatory cells that would define this as NGU. EWH
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93 months ago
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Thanks so much for you reassuring reply Dr. Hook. Yes, I have been completely faithful and monogamous with my wife since that misstep. The test I took was indeed an IGG blood test administered through LabCorp on 8/30/16 (part of the overall panel of test) which tested for HSV1 and 2 - the result was negative (<0..91 per the report) for both strains - hope that provides more clarity.
Also tremendously relieved that what I'm experiencing is likely due to normally occurring bacteria. How long does it normally take for this sensation to resolve? As I mentioned, I really only noticed it on Monday of this week - prior to this, I believe I may have irritated my urethra while in the shower as I'm pretty sure I ended up getting soap in that area. That was initially uncomfortable for a couple days but resolved on its own - then I felt this current sensation this week, and my anxiety took off!
Does this mean I can confidently assert that I shouldn't be driving myself crazy worrying about herpes? I think you're right that this lingering sense of guilt is not at all helpful!
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Edward W. Hook M.D.
93 months ago
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Yes, you are worrying needlessly about HSV.
As for resolution, there are no good data. If the sensation becomes troubling or gets worse you may want to seek the evaluation I described above. If signs of inflammation are present, it responds quickly to antibiotic therapy. EWH
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93 months ago
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Dr. Hook - thanks again for your informed counsel with regards to my concern. You have no idea how relieved I am!
This site is a godsend, thanks so much for the work you do!
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93 months ago
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Just one more question if you'll let me Dr. Hook. There's no need for me to take any additional HSV tests aside for the reassurance that negative results will provide right? I figure I should be able to rely on my negative test results from 8/30/16 right?
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Edward W. Hook M.D.
93 months ago
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Correct, since your blood test was performed more than a year after the extra-marital exposures you described, there is no need for further testing. Blood tests for HSV are as conclusive as they will ever be at all times more than 6 months beyond a potential exposure. Be confident of the results.
As you know, we typically provide up to three responses to questions. This is my 3rd response and thus this thread will be closed later today. Take care. EWH
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93 months ago
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Dr. Hook, I think you misread the dates of when I took the tests. The tests for HSV were taken on 8/30/16 and my misstep was on 8/1/16.. so does that mean I should go and get tested again in spite of no symptoms over the last 15 months?
My heart just sank on this reply as I've been having unprotected sex with my wife since my tests back in August of last year..
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Edward W. Hook M.D.
93 months ago
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From a practical perspective, if you asked me if you needed to test for HSV I would have said no. Given your absence of symptoms and test results, I see no reason for further testing for HSV. You really need to move on.
This thread must now be closed. EWH
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