[Question #3807] Hsv2/other sti/prostate infection

36 months ago
Greetings,

I have had unprotected sex with a stripper since April 21.  She said she is negative.  On May 3 however I noticed burning when I urinate and foamy urine.  The burning has dissipated a bit but is still there.  At that time I also noticed a red rash on both sides of my groin/leg crease which has not completely faded yet.  I thought this was irritation from frequent sex.  But yesterday June 3 I noticed during masturbation that my semen is completely yellow and it hasn't gone away.  I also noticed a couple of red bumps near the head of the penis as well.  I haven't noticed the bumps or rash becoming open lesions and they are not painful but I have heard herpes can go unnoticed.  I also haven't noticed any discharge save for the yellow semen.  My lower abdomen has begun aching as well. 

1) Does this sound like hsv2 or another sti?  Why or why not?  

2) Is this a uti or prostate infection? 

3) What causes yellow semen?  If due to an sti why is it yellow a month after first exposure?

4) For testing, is it best to go to a walk-in sti clinic or would urgent care be more thorough (prostate exam, semen collection)? 

Thank you so much for your help and expertise.
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Welcome to our Forum.  I'll try to help. As I understand it, you had sex with a stripper on April 21 (more than 6 weeks ago).  Shortly after that you had burning on urination (which is compatible with an STI) and foamy urine (which does not suggest and STI).  Simialrly, the redness on the inner aspect of yoru leg does not suggest STI either.  I have no explanation for your yellow ejaculate.  Thus may recommendation is that you need to see your own doctor.  you need testing for common STIs, most importantly gonorrhea and chlamydia, and you need a urine culture.  I can assure you that this is not herpes.  In answer to your specific questions:

1) Does this sound like hsv2 or another sti?  Why or why not?  
see above.  Putting all that you say together, the only things that MIGHT even suggest STI are your burning on urination 6 weeks ago and your yellow ejaculate now.  The other symptoms in no way suggest STI.

2) Is this a uti or prostate infection? 
Thee are possible.  It is for this reason that I suggested that you see your own doctor and that an urine culture  be part of your evaluation.  I strongly recommend against starting antibiotics without appropriate tests as suggested. 

3) What causes yellow semen?  If due to an sti why is it yellow a month after first exposure?
See above. The timing suggests that it is unrelated to the exposure you mention. 

4) For testing, is it best to go to a walk-in sti clinic or would urgent care be more thorough (prostate exam, semen collection)?
A true STI clinic would be preferable, particularly if they can culture your urine for routine bacteria.

I hope these comments are helpful.  EWH
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36 months ago
Thank you Dr. Hook,

This is very helpful.  Also, to clarify: I have been having sex with her since then but not in the last few days (perhaps she has contracted something else).  I hope you don't mind if I follow up on some of your responses.  

1) Could you clarify why this is not herpes?  I have read herpes can cause yellow semen so that is why I ask.

2) Is it possible that it is gonorrhea or chlamydia even though I have not had a discharge - or is yellow semen considered "discharge."

3) Could you explain why you do not recommend taking antibiotics until testing is done?  I don't know how long my clinic takes to get results and perhaps they might give me something the day I go in (probably tomorrow).

4) Finally, (I don't know if you can answer this).  I have surgery on my elbow and hand on Friday.  If I go on antibiotics typically prescribed for STIs will that interfere with anesthesia or surgery recovery?

Thank you again.
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago

1) Could you clarify why this is not herpes?  I have read herpes can cause yellow semen so that is why I ask.
I have no idea where you read this but the statement is just plain wrong in every way.  There is absolutely nothing here to suggest that this is herpes.

2) Is it possible that it is gonorrhea or chlamydia even though I have not had a discharge - or is yellow semen considered "discharge."
About 5% of gonorrhea does not cause symptoms.  That is why I suggested you get tested to be sure.  If this were gonorrhea, it would be a most unusual presentation of infection- one that I have not seen in nearly 40 years of STD focused practice but anything is possible. 

3) Could you explain why you do not recommend taking antibiotics until testing is done?  I don't know how long my clinic takes to get results and perhaps they might give me something the day I go in (probably tomorrow).
I recommended not starting antibiotics until the tests are obtained.  If the health care professional who you see thinks antibiotics are warranted, then they could be started before your esults are back but you should be tested first.  Otherwise your test results are not going to be reliable and you will have lingering doubts.

4) Finally, (I don't know if you can answer this).  I have surgery on my elbow and hand on Friday.  If I go on antibiotics typically prescribed for STIs will that interfere with anesthesia or surgery recovery?
No, antibiotics taken for a UTI or STI would not negatively impact your surgery.

Hope this clarifies things.  EWH
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