Herpes or what?

[mat18]

Hello, I am a 21 year old male. I've never had vaginal sex however i have recieved oral sex on numeral occasions. My problems have started before i even did anything sexual with anyone else. At age of 16 i've noticed a permanent yellowish rash on the tip of the inside part of my foreskin. I believe this was due to the fact that i did not wash my penis for a while, because it hurt to pull the foreskin back. at the age of 17 i began having a lot of burning while i urinated. finally, at the age of 18 i recieved a handjob from a girl. the next day  i woke up in pain and with sores and yellowish discharge all over my penis. since then ive had redness and small bumbs on my penis that usually occur after masturbating or sexual contatct. i also get itchy around my anus and testicles and feel a burning sensation while urinating. i finally decided to go to a urologist who by a physical examination decided that i do not have herpes and that infections are caused due to the tightness of my foreskin. He proposed that i get circumcised. The procedure was carried out two weeks ago and i am still healing from it. this friday i started to notice redness and felt tenderness around my penis. the next day i woke up to find a small red/painful/itchy/tender bump right under the head of my penis.

i have had high levels of herpes 1 in my blood since i was very young (this was determined by a blood test) and always have had oral outbreaks. i guess my question is if the oral herpes 1 can somehow spread to the genital area? the bump on my penis isn't a blister but it feels very similar to what a cold sore would feel like. also the head of my penis looks very dry and red. i trust my urologist but i know that herpes can be very easily misdiagnosed and im just looking for a second opinion. also, should i, based on what i have described here, ask my urologist to perform herpes tests at my next visit? i did get tested for genital herpes once at an std clinic. they performed a test that involves a cotton swab being forced inside the penis. i've recently learned that that sort of test isn't always accurate. i am just really confused.

[Alan Rockoff, MD]

Northing you've described sounds anything like herpes.  Positive herpes 1 titers just mean you've been exposed to the cold sore type of herpes sometime in your life--it has no implications for genital herpes.

I don't think you have anything to be confused about.  You had a surgical procedure--circumcision--and you seem to be having some mild, postoperative changes.  You should check these out with the urologist.  But herpes doesn't seem relevant to me at all.  You can get genital herpes from oral contact, but your symptoms don't match herpes.  Ask your urologist again...

Take care.

Dr. Rockoff

[mat18]

I forgot to mention that the swab test was negative.