[Question #3241] STD or UTI?

39 months ago
3 weeks ago I visited a strip club where the stripper fingered herself a little and then gave me a hand job; I'm sure a little of her vaginal fluid came into contact with a wound I had on my penis. 11 days after, I had a full panel STD test done and everything was negative; I also had an HIV RNA Early Detection done after 2 weeks which was also negative. I know from reading the forums here and Medhelp that I was in a low risk situation, but the past 2 days, I've had a tense/pressure feeling on my penis head and a constant feeling to urinate. The urge to urinate gets worse towards nighttime. Very little urine comes out and there is no pain/burning nor does the urine smell foul. Further, there are no sores or lesions present. Should I redo the STD panel now after 21 days? I'm under 30 and not sexually active outside of the above mentioned incident so I can't really tell how I can have a UTI. Thanks for your help.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Welcome to our Forum.  the encounter you describe was not low risk, it was NO risk.  STIs are not transmitted through transfer of genital secretions in the process of masturbation and the presence of a "wound" in no way changes this fact.  There are no instances in which any STI, including HIV have been transmitted in this way.  Had you asked whether or not you needed testing for any STI, I would have said no but since you have tested, these results simply confirm what I have said, you did not (and could not) get an STI from the sort of exposure you have described.

Further, I should add the urinary frequency and hesitancy are not symptoms of an STI.  In fact, we have just had a paper accepted for publication in a medical journal (it will not appear in print for several months) which makes this very point.  Urinary symptoms of the sort you have described may be present with a urinary tract infection which could be diagnosed with a urinalysis or with a prostate infection, both of which are uncommon but do occur in young men. Since the treatment for the two infections, I would urge you not to allow yourself to be (or seek treatment) without knowing what you have however since the two processes are treated in different ways.

I hope this information is helpful. Take care.  EWH
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39 months ago
Thank you for your answer, Dr. Hook. 

Understanding it was a no risk event (no oral/vaginal/anal intercourse), I would like to ask one more question. Is it at possible to get HSV bumps after over 3 weeks after exposure for an incident like I had? I examined my inner foreskin and noticed 7-8 tiny light colored bumps (can only really see them if the skin is stretched out). They are painless and I wouldn't have even noticed if it wasn't for the symptoms I explained above (urgency to urinate, tense/pressure feeling on penis head). Is it safe to say that's nothing to worry about and that I'm overthinking it? 
39 months ago
After some searching, I came across something called "fordyce spots". Although I can't find a good picture to compare my spots to these, it sounds similar (painless, tiny, white, round bumps). I'm only concerned because of the symptoms I've kept alluding to and the fact that these bumps are all located in one area and are not all over the foreskin. Would you be able to clarify on this point as well?

Seeing as this is my third comment and I won't be able to comment again (?) I would like to sincerely thank you for your help and this wonderful service.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
The lesions you describe do not suggest herpes, not would the encounter you describe put you at risk for herpes.  Herpes lesions are typically uncomfortable and do not appear as bumps but as small fluid filled blisters which quickly break to become open sores (ulcers).  Further herpes lesions typically appear within 14 days of exposure and it would be most unusual for herpes lesions to appear at three weeks following exposure.  What you describe may be Fordyce spots or pearly penile papules, both of which are normal findings on the male penis.

FYI, while you made 3 comments, this was only my 2nd reply so you may follow-up with an additional question if need be although I remain confident that you are not at risk for STI and that additional questions will not be needed  EWH
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39 months ago
Thank you again, Dr. Hook. My PCP put me on a course of cipro for the potential UTI symptoms. I hope the symptoms diminish in the next few days.

The white bumps don't resemble typical HSV-like ones I've found in pictures, nor do they look like blisters as you explained (although they're so small that it's hard to tell). I'll keep monitoring them to see if they break up into ulcers. 

Just two final questions: 1. Can Fordyce spots show up in a single cluster/bunch/region in the inner foreskin and not be found elsewhere? Most of the pictures online show them being more widespread. 2. In the absolute unlikely but off chance that these bumps are representative of HSV, would a blood test at this point (3.5 weeks post exposure) be suggested and could it accurately represent the infection?

Thank you again, Dr. Hook. Appreciate your help and confidence tremendously as this anxiety has been eating me alive.
39 months ago
Dr. Hook, a third question along with the other two (and hopefully this puts it all to rest!) Can a UTI cause a random, sharp pain on the penis (very intermittent, it's only happened 2 times today)? Can it rather be a result of HSV? I'm going to stop reading things on the internet after your response and let time tell.

Thank you again.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Fordyce spots do not need to be widespread. They can be very localized.

Antibody tests can take up to sim months after the appearance of lesions to become positive.  However, I urge you to give up on the idea of herpes.  There is NOTHING you have described to suggest that you have acquired this.

UTI's like STIs do not cause intermittent/episodic pain.  The pain you describe is most compatible with prostate problems or stones within the urinary tract or prostate- neither of these is an STI. 

Finally, PLEASE stay off the internet.  Going to it will do nothing except fuel your anxiety and mislead you.  This will now end this thread and it will be closed shortly..  Please give up on the idea that your symptoms are due to an STI.  NOTHING you have reported suggests this.  Take care.  EWH
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