[Question #4681] HPV, testing, symptom confusion

28 months ago
This has been going on for about 4 weeks. Symptoms are shooting pain into urethra opening that radiates to my head, also seem to have super heightened sensitivity. Have done multiple tests thru my urologist including STI was negative, urine test negative, urine culture negative but found a few WBC when checked microscopically. All the basic infections and stis have been ruled out. My search has led me to suspect HPV, Trich, mycoplasma  or something similar causing something called Urethritis.  Urologist stated I have no urological problem.
1) Given the testing this far and results where should I proceed from here? Btw symptoms are not anxiety really is happening 

2) Are any of those 3 STIs I mentioned possible in causing Urethritis? 

3) Do you have any possible scenarios that could be doing this? 

4) I've been googling everything I can. Is it probable my Urologist is wrong. Also anything as far as more testing you reccomend?

28 months ago
ThNks in advance.Also is there a doctor besides a urologist that I may want to consult about the issue?
2) I'm in just a rut. Ut feels almost like s pain that stops me in my tracks. Does this have a ring of anything to it?
3) it seems to be a bit around my urethral opening though my wife says it is normal. In light of normal urination, no discharge, no blood, no dysuria but continuing pain any ideas? 

4) The pain seems to start after I first urinate for the day. Never during urination only when not. Doxycycline didnt work. Anything else I can try?
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Welcome to the Forum and thanks for your confidence in our service.  You don't say anything about why you are worried but I can tell you that complaints such as yours are not uncommon on our Forum and are virtually never caused by STIs.  Typically they go away without therapy over time and STI tests are negative.  .The presence of WBCs in your urine is suggestive of an inflammatory process in the urinary tract, including the penis and falls under the broad category of "urethritis".  Urethritis can be caused by organisms such as gonorrhea or chlamydia which it sounds like you have ruled out, as well as trichomonas or mycoplasma genitalium which you have apparently not been tested for.  It might be worth getting tested for those organisms, particularly M. genitalium which is emerging as a cause of persistent urethritis in a small proportion of men.  As I said above however, your urethritis, as manifest by WBCs in your urine, may not be at all related to the symptoms which you describe.  

If you wish to pursue the urethritis diagnosis, get tested.  Otherwise my advice is to wait this out.  If you wish a second opinion, a sexual health/STI specialist might be preferable to another urologist.  EWH
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28 months ago
My fear is that HPV is causing this. All other STIs have indeed been ruled out. A few have told me this doesn't sound like Urethritis at all. I'm worried that HPV was missed and is now causing cellular changes which will lead to Cancer. I've consulted Dr.HHH and yourself before in the past and was told HPV can't be the cause. This will be my final time about this as you have been so helpful.
1) Is there any logical chance of this being HPV Urethritis?

2) Urologist saw a few WBC only under microscope but didnt think it a big deal. Given a clear urethra tract based on what he saw does that clear me of anything dangerous?

3) He just mentions nothing urologically is going it. Idk what that means. I haven't had sex in 2/3 months and only with wife. Given that and everything I've said what would be your opinion and advice?
4) I'm desperate for answers and I'm worried this will be fatal. Thanks in advance
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
HPV does not cause abnormal sensation- period!.  

I'm not sure who you are talking about but if there are WBCs in your urine or a swab from your penis you have urinary tract inflammation.  If the WBCs are not coming from your bladder or kidneys' (which apparently, the urologist has ruled out), then the most likely place they are coming from is your urethral.  By definition, this is urethritis. I agree with Dr. Handsfield, HPV doe NOT casse urethritis and does NOT cause the sorts of shooting pains and increased sensitivity you describe (told you this above).  Thus:

1) Is there any logical chance of this being HPV Urethritis?
No, see above

2) Urologist saw a few WBC only under microscope but didnt think it a big deal. Given a clear urethra tract based on what he saw does that clear me of anything dangerous?
The inflammation detected may or may not be a big deal.  Small numbers of WBCs can certainly be normal.  The urologist examined and tested you, I did not. I will defer to him.  

3) He just mentions nothing urologically is going it. Idk what that means. I haven't had sex in 2/3 months and only with wife. Given that and everything I've said what would be your opinion and advice?
I would not worry and certainly would not continue to abstain from unprotected sex with your wife.  

4) I'm desperate for answers and I'm worried this will be fatal.
If this were serious enough to be dangerous or fatal, I suspect your urologist, who sounds quite thorough, would have found something.  I think you need to take a deep breath, relax and ride this out unless it gets worse.  If it gets worse, you need to go back to the urologist who has seen you before.  EWH

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28 months ago
Dr. Hook thank you so much. So to be clear to the point here. HPV cannot be the case according to you and multiple other folks including the great Dr HHH! 
1) You guys are awesome and have helped me somewhat maintain at least a bit of normalcy.
2) The Urologist didn't believe Urethritis was happening, instead he highly suspects Dietary issues like caffeine doing it. Unreasonable I guess?
3) For the final and very last time, you're saying that HPV can be ruled out 110% as the cause of these symptoms? 
Thank you!!
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Thanks again for your thanks.  No matter how many times you ask the question, the answer is not going to change.  HPV would not be causing the symptoms that you are describing.  You need to put this unreasonable concern away and move past it.

As for the "urethritis" issue, I think we are getting into a semantic issue.  If there were an abnormal number of WBCs in your urine or a swab from your penis, you have inflammation there.  Whether it is pathological or not is another and DIFFERENT story.  If you must go see your urologist to discuss again.  Otherwise, just relax and move forward.

As you indicate, this will end this thread.  Should you return with more repetitive or anxiety driving questions, the question may be deleted without a response and without t return of your posting fee.  EWH
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