[Question #4137] Question #3378 - Follow-up, 6 Months Later

84 months ago

Doctors,

I had submitted a question some period ago regarding an incident, which was hand to genital contact (at least what I can recall). My penis was rubbed pretty aggressively prior to me pulling her hand out of my pants. I am revisiting this site because I am still having symptoms, which have not been resolved after a year. This is not an anxiety driven post, but someone who is still seeking help by people who can think "outside of the box" - like yourselves.

My continued issues:

1. Redness / rash on top of glans, sometimes skin appears shiny. Comes and goes.

2. Blotchy rash, dry skin on glans post erection, skin turns dark red post erection sometimes.

3. Swelling around meatus, general swelling

4. Pain in the glans region when touched, sensitivity overall, constant dull pain

5. These issues are more noticeable post urination, also have dribbling / urine trapped in glans

6. Malaise, dizziness at times - maybe not related.

Since our last exchange, I have had multiple urologist appointments, but nothing has been conclusive. There seems to be some conflicting viewpoints. The only diagnosis I have been provided with is "nerve pain" - which seems rather generic, and I have been put on different medications, used off label. They have not worked. I have also visited two dermatologists as well who have put me on creams, steroid and non-steroid. They have not worked either.

Again, could there be any possibility this is one of the HPV strains that I am dealing with? Something that has infected my skin. Perhaps you have another suggestion for me. I only go back to HPV as it can be passed via skin to skin contact (Herpes too but this does not look like, and the duration is too long for Herpes) and my knowledge of STI’s is limited.

Edward W. Hook M.D.

84 months ago

Welcome back to the Forum. I am sorry to hear that you continue to have these difficulties. Having just reviewed your prior interactions with both me and Dr. Handsfield, I see that little has changed both in terms of your symptoms and in terms of our assessments. The symptoms that you describe are no those typical of any STI, including HPV and I remain skeptical that they are related to the virtually no risk exposure that you have described.

From time to time there are instances when problems appear in an early stage which are difficult to characterize but with repeated examinations and evaluation by the same clinician they may declare themselves, leading to improved management. I'm sorry I don't have more to offer than that you identify the clinician (hearing your descriptions, I would probably favor a dermatologist over a urologist) whom you feel is hearing your concerns and commit to working with him/her over time. Sorry I do not have more to offer. I DO remain convinced however that this is not an STI. EWH

p.s. I doubt that your malaise and occasional dizziness are direct consequences of this problem although your own concerns may be contributing to these symptoms as a secondary effect. ewh

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84 months ago

I am 100% positive that my penile issues are related to this event. The symptoms described started and progressed in the days after. As noted, I do recall a very sharp pain when this happened, which I keep going back to in my mind.

Whether I have an STI or not, this is where I value your and Dr. HH's expertise (and other physicians). All I can do is describe my symptoms and try to find the best subject matter expert . As discussed, my STI testing did not yield any positive results. I have been scoped, had an ultrasound performed and also had a cystourethrography study. My blood cells counts were in range, etc. There were conflicting thoughts on my cystourethrography study, but a surgeon ultimately ruled things out.

By process of elimination, I found myself returning to see if your opinion would change regarding a viral infection. But I am concluding that you have not seen male HPV cause these symptoms of redness/inflammation of the glans as well as pain (feels internal btw). I do recall Dr. Handsfield's point regarding pain, stating that it is not a symptom of HPV.

With respect to the malaise, dizziness and blurred vision (floaters in eyes), there is a chance that it could be a result of nerve pain medication. I will continue to see my dermatologist per your advice. The pain does feel internal however, and I think perhaps the external issues are due to internal.

Q2: Would you deem me okay to have intercourse or do you think there is anything else that I should test for, such as Adenovirus, etc. or any additional blood tests to take just to rule things out and test for inflammation in the body? I have abstained since this all started.

For full disclosure, I also had sinusitis (never had before in my life) and a sore/red throat after this event, which is resolved. I had dry mouth / white tongue for a period of time and still have continued tightness in my throat. I have read your posts about contact with breasts, even oral contact (sucking, licking), where you have stated that no STI is passed. So, perhaps these are my concerns contributing. I have been healthy for 33 years and now I end up with all of these strange issues.

Edward W. Hook M.D.

84 months ago

You are correct, my assessment and opinion regarding a viral STI (HPV) as the cause of the genital (and other) symptoms you are experiencing has not changed. I have never seen, nor heard of anything even close to this being caused by HPV.

Q2. I see nothing from the information you have provided to suggest that it is not safe for you to have unprotected sex with others and nothing to suggest that you have something that might be transmitted to them. I see no need for further testing.

I wish you the best. EWH

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83 months ago

Thank you. I am struggling to understand what is going on... and clearly you feel that based on the information I have presented that I am not infectious, which continues to help put me at some ease.

Q3. I have read a number of posts where health forum members have expressed many of the symptoms outlined above and in my prior posts - but all common STD tests are negative. There are threads that are pages and pages long - where men are suffering from pain and rashes (assume non-HSV, HPV) and are diagnosed as being STD free, etc.

Many of the symptoms of forum members seem to be similar and the cause is often reported to be some type of sexual event - not necessarily intercourse (who knows how much of this is accurate, which I understand). There are theories of virus, nerve inflammation/pain, etc. floating around these threads, which I am sure that you are aware of. Doctors are often reported as not being able to diagnose a condition. From your experience, how do many of these issues resolve (as the symptoms are likely real, not anxiety fueled)? I am sure that you have dealt with it many times in your career and you can obviously toss me into this group.

Edward W. Hook M.D.

83 months ago

I am sorry for your continuing struggles. Please remember, I am not discounting your symptoms. There is only so much I can do within my own area of specialization (sexually transmitted infections) and even that is somewhat compromised by the fact that such interactions are over the internet and so I do not have the ability to personally examine you or take a more in depth, comprehensive history for alternate explanations (and I am not suggesting that I need to). What I can do however, based on the information you have provided and my years of experience and research is to be quite confident that your problem is not a sexually transmitted infection that might have been missed by testing or which might put you or sexual partners at risk for complications. There are many non-STI causes of rashes and other symptoms which happen to occur in the genital regions or which may coincidentally manifest themselves following a sexual encounter which other health care providers or specialists may recognize.

Similarly, the nature of this forum does not assure me complete follow-up on all clients who come to us. That said, it is my sense that with time some of these problems declare themselves (one should not discount the importance of having a problem followed over time by the same health care provider so that they can determine the evolution of a process) or resolve over time and without specific explanation or therapy.

I wish you the best. Again, I am confident that this is not an STI and that it does not put you at risk for transmitting it to others. As you also know however, as this is my 3rd response to your question, this thread will be closed later today. Take care. EWH

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