Burning sensation in penis-- HSV?

[Kingsky]

Hi-- I had a brief unprotected oral sexual encounter with an acquaintance 7 days ago.
She performed unprotected oral sex on me for about a minute before I stopped her.  A day or so later, I developed a stinging feeling in the tip of my penis.  It doesn't hurt when I urinate, I've not noticed any discharge, blood or strange smells.  The pain gets better when I take Advil or pyridium.  I went to a urologist on Monday and he didn't think there were any indications of an STI-- he prescribed z-pak for the burning and that has helped.  He did test my urine for STIs and the test was negative, but was positive for UTI.  
I'm wondering if any of this is consistent with HSV--  I've been feeling warm and flush (no fevers so this could jut be a Zpak side effect).  No rashes or blisters but I'm concerned that it may be incubating.  Today, I  noticed a small pimple-like bump on the shaft of my penis (I tend to get these and I was able to squeeze it and get some "junk" out but now its somewhat red and swollen).  I've also had some hip pain as well as general anxiety.  
Please let me know your thoughts!  Much appreciated.  

[Kingsky]

Thanks again for all your advice, Dr. Hook.  My doctor thinks this may be prostatitis and put me on levaquin for 6 weeks-- I'm in the second week and things seem to be improving (although sometimes there are setbacks).  This morning, however, I noticed a single small red dot on the shaft of my penis.  It could be the result of those whitehead like bumps that I sometimes squeeze to extract (I know that I shouldn't)..  It doesn't hurt when I touch it and doesn't seem to have any puss inside.  Do you think this could an hsv outbreak?  I know you have thought that I didn't have to be concerned but I was wondering if this new info changed your views.  It's been over 6 weeks since the encounter, and I remain somewhat anxious because of the persistent on and off burning and now this new development.  Thanks again!

[Edward W Hook, MD]

The  absence of lesion, the fact that this continues, and the fact that your tingling is occurring at multiple locations are all inconsistent with herpes.  While I do not have an explanation for what is going on, I see no reason to be worried about herpes.  EWH

[Kingsky]

Oh.  And, I forgot to mention that I have a little tingling in my face, eyes and feet too.  I think this may be a side effect of pyridium or anxiety but wanted to make sure this didn't change things.  Thanks.  

[Kingsky]

Thanks, Dr. Hook.  I'm really trying to move on and your advice really helps.  The problem is that I'm still having some burning and tingling sensations and don't appear to be getting better.  I've read that sometimes HSV-1 is so mild that it isn't that noticeable so I'm worried that I'm just missing something.  I'm not even really sure what it looks like.   Still no lesions or blisters.  I would think by now is be in the clear but the stinging still persists.  Thanks again for your help.  

[Edward W Hook, MD]

I agree with your doctor- you need to put aside your concerns aobut STDs, including HSV.

When HSV involves the urethra, there are typically lesions present as well

EWH

[Kingsky]

Thanks for all your help.  I was hoping that would be the end if it-- my initial symptoms did go away an for abut 10 days I was feeling back to normal.  Then, last Friday (3 weeks after brief unprotected oral sex), I noticed a slight stinging feeling back on the tip of my penis.  The stinging was less intense than the initial episode.  I also experienced some sharp pains inside my gut in my pubic region on the right side.  Over the weekend, i noticed a little difficulty urinating, like i had to push a little to get it started.  The doc put me on more antibiotics (cipro this time) and flomax to help with urination.  The doc continues to think no STI and I've never had lesions or blisters but I'm concerned that this may be HSV-1 inside my urethrea, etc.  Is this even possible?  Thanks.

[Edward W Hook, MD]

No change in my recommendations or assessment. Your bumps may be molluscum contagiousum for which there are better managment approaches than squeezing them.  EWH

[Kingsky]

Thanks, Dr. Hook.  Appreciate the quick response.  The "bumps" look like whiteheads to me and I've had these on my penis for my enore adult life.  Sometimes I extract the whitehead but usually I leave it alone.  This one I extracted because of anxiety and its a little different looking than I remember but it doesn't appear to be a blister and its the only unusual "bump" that I notice.  Not sure if this changes anything or how worried I should be at this point given its been over a week.  Thanks again.  

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help.  Several thoughts.

To your question about HSV first- no this does not suggest HSV.  If you had HSV and your symptoms were due to this, you would have lesions too.

That naproxen (Advil) and pyridium help is no surprise, these are analgesics but do not help the underlying cause.  

Your tests prove that you do not have gonorrhea or chlamydia but did not rule out non-gonococcal urethritis which is what I suspect you have. NGU is among the most common STDs acquired from oral sex and seems to be caused in such cases by the introduction of normal mouth bacteria into the urethra during oral sex.  Some doctors mis-identify NGU in men as UTIs- the fact is the UTIs are VERY rare in men under age 40 and most men who have “evidence” of UTIs actually have UTIs which is manifest as the presence of white blood cells in a urine specimen.   The process typically gets better with azithromycin and rarely, if ever, leads to complications.  Sometimes it takes a few days following therapy for the symptoms to resolve.

Stop squeezing these "bumps".  Not sure what you are describing and my advice would be to see a health care provider the next time one appears to get a diagnosis.  Squeezing lesions of this sort however increases your risk for creating an infection.

I hope this helps.  My suspicion is that you had NGU.  If so, you have been appropriately treated.  HSV is not a concern.  EWH