Weeks of pain, what can this be

[Brd64]

Doctor,

6 weeks ago I had unprotected oral sex, 3 days Later I started to develop pain on the tip of my penis with some red irritation at the opening as well.  Now 6 weeks later I still have a sharp pain at the tip of my penis as well as testicle pain and tenderness.  I have been tested 2 times for gonorrhea with negative results within the first 3 weeks. Tested at 5 and 21 days out. However I did go on a zpak and was off of it for about 9 days before I had the second gonorrehea test. Could this have affected the 2nd test?   I did test positive for HSV-1 with an IGG level of 8.0 at 18 days after exposure.  I have been to the urologist and have completed a prostate ultrasound and some type of prostate culture and all he can say is your tests have been negative.  I have been on 100 mg once daily of doxycyline  for 25 days now.  I have had this pain now for 5 weeks with no improvement and never had any sores, lesions or discharge but the pain is constant and hurts every minute of the day.  The pain feels like there is catheter in my penis which radiates like nails at the tip with pain also hurts when you squeeze the penis tip but no burning while urinating.  Can this be NGU HSV herpes  or something else like another STD or prostatitis.  Any advice on how to proceed would be great.  Just want to find a way to make the pain stop.

Thanks

[Edward W Hook, MD]

Sorry for the delayed response.  These symptoms are really not at all suggestive of herpes. Further, herpes almost never occurs only within the penis and at the level of positivity that your test shows, the HSV-1 test may be a false positive test.  Even if it is a true positve test, this would not explain your discomfort.  EWH

[Brd64]

I did not know if I had to start a new thread or if I did not respond the right way. Please advise on the following..  My urologist feels that even with no sores to see and that he ran the Hsv1 test again this time with a igg level of 1.7 and that this maybe the source of my problem so he is putting me on valtrex. Is oral herpes (hsv1) on the genitals possible without sores and only the pain listed above and be inside the body where it can not be seen?  And if so when herpes is only found inside the penis does it take longer to heal? Thanks again.  

[Brd64]

My urologist feels that even with no sores to see and that he ran the Hsv1 test again this time with a igg level of 1.7 and that this maybe the source of my problem so he is putting me on valtrex. Is oral herpes on the genitals possible without sores and only the pain listed above and be inside the body where it can not be seen?  Thanks again.  

[Edward W Hook, MD]

No, the magnitude of your IgG for HSV-1 is of no consequence in terms of explanation for other symptoms.  It just means that you have this infection, as to over 60% of American adults.  EWH

[Brd64]

Should having a hsv1 igg test at 8.00 but negative for Hsv2 be of any concern, does the high number mean anything ?

[Edward W Hook, MD]

Welcome to the forum. I cannot tell you what it is that is causing your discomfort but I can tell you with confident that despite the fact that the discomfort was first noticed soon after a sexual encounter, that it does not sound like an STI. There are no STIs which characteristically cause this sort of discomfort, not are there STIs which would cause this sort of pain for more than five weeks without obvious lesions.  (I presume your urologist looked at did not see lesions).  further your STI tests are not at all suggestive of infection.  My advice is to continue to work with your urologist to sort this out.  

I hope this comment is helpful.  EWH