[Question #831] last follow up toquestions 603 and 705

89 months ago
Hi Dr
Here is an update to questions 603 and 705. 
 The agrivated uerthra opening has persited for 11 weeks now. No discharge and slight burning only after urination and ejaculation. Once in awhile I get what feels like a needle stick in the tip of the penis.  I seem to urinate more often as well. No inflamation or lesions of any kind.
 At two weeks I tested for bacterial sti's including trich. All negative as you said they would be. I let the idea of an sti out of my mind and told myself it's just me being stressed about the encounter. Symptoms persisted but it's not severe just annoying.  I'm in my fourties and this could just be the way it is or maybe a prostate issue?.
 I said screw it and at 10 weeks tested for everything.
Hep b and c-neg
Hsv 1 and 2-neg

It also came with cbc and complete urinalysis.  All was normal. No wbc, bacteria,  rbc or protiens in urine. Did see mucas threads. So it would seem no infection was present.
 To my one question which I know is a long shot
1. How accurate is my hsv test at ten weeks. If what I was experiencing is some kind of herpes urithrits would I be safe to assume there would be wbc in my urine test? I know this is a long shot so don't beat me up to bad.lol
I'm not even that stressed over this because I truely believe it is not a sti. The only thing that gives me pause is it started 4 days after the encounter. The symptoms have subsided for a few days here and there but for the most part been very consistent.  Thank you in advance for your thoughts. Oh and I have read about guys with the same symptoms and none of them ever seem to test positive for any std's
Edward W. Hook M.D.
89 months ago

I'm sorry you continue to have symptoms.  I happened to pick up your follow-up post today.  I did review your earlier interaction with Dr. Handsfield following our initial interactions.  As you can see, he and I are on the "same page".  

I am confident that they are in NO way related to the sexual encounter you described over two months ago. There is no realistic way that the experience you described would lead to acquisition of herpes urethritis, nor is it reasonable to think that you continuing symptoms are due to herpes urethritis. When men get herpes urethritis, they have lesions- you have not. Further, if you had herpes, 95% of persons with herpes would have developed a positive antibody test at this time.  it is (past) time for you to put the possibility of herpes aside.

Despite your comments to the contrary, I believe that your continuing, intermittent symptoms are a manifestation of some combination or guilt and anxiety over the exposure you described, not an infection. 

Some of your symptoms are vaguely similar to this described as part of the chronic pelvic pain syndrome in men (CPPS) which is well described in Wikipedia.  You might take a look,.

Hope these further comments are helpful. EWH

89 months ago
Thank you Dr. Hook. 

I read you loud and clear. It's time to let it all go. Your sevices are truly appreciated. 
Edward W. Hook M.D.
89 months ago
take care.  EWH