Inflammation of penis??

[mjones02]

I’m in desperate need of some answers. About 4 or 5 years ago I received unprotected oral sex with a girl that I did not know and that same night I had an unusual feeling around the head of my penis, almost like a tingling/tickling sensation. Ever since, I’ve developed the following symptoms: I get recurrent burning on the head of my penis. I continue to feel a tingling sensation at times and I experience mild burning occasionally throughout the week. The severe burning and inflammation is usually triggered when I’m under stress or if I get a flu or cold, i.e. when my immune system is compromised. Also a round mark/spot has developed on the tip of my penis that has approximately the size of a pencil eraser, it looks like it is several layers under my skin and it is encircled with a brownish pigmentation of the skin.  It does not appear when my penis is erect, and the center is whitish in color when my penis is not erect. It does not hurt or itch but at times I do feel a slight tingling. Several times when the severe inflammation is trigerred, the same white mark hardens up and it appears that there may be fluid in it, although it does not get elevated above the skin level and it has never burst and never discharged any fluid. It is somewhat similar to a burn blister but without the elevation. In addition to this mark that is constantly there, a couple of times when the inflammation was severe there was another area on the head of the penis that developed a similar "blister" maybe a little larger, however, it goes away after the inflammation subsides and it does not reappear (again it does not break and is not elevated above skin level).   The inflammation causes a red rash on the head of the penis, but it is not dry or itchy.  

Initially I thought it may be herpes since I get similar symptoms (I think), however I was tested several times a couple years after the incident and all tests came back negative for HSV 1 and HSV 2 (I did both the IGG and IGM tests and recently redid the IGG with HepeSelect). So my doctor has ruled out herpes.

Because all this started to develop after the unprotected oral sex, I think it’s an STD but my GP does not think so and all tests came back negative (syphilis, chlamidya, genital warts). I thought it may be some sort of a yeast infection and asked my doctor to prescribe medication. He prescribed antifungal topical cream, Ketoconazole 2%, which I used for about 3 weeks but it does not look like that’s working.

I have no idea what this recurring rash is, I’m not sure what else can cause recurring burning sensation and “blisters” other than herpes? What about syphilis, my doctor did the VDRL blood test but I just read that that may not be accurate all the time, although I don’t appear to have the textbook symptoms of syphilis.  This is driving me crazy and I can’t seem to put any closure to it. Any help is much appreciated!!!

[H. Hunter Handsfield, M.D.]

Neither herpes nor any other STD causes the symptoms you describe.  The risk of STD from oral sex is very low.  Several years have passed without development of more typical symptoms or complications.  Your doctor can't find anything wrong. And your tests for all common STDs are negative.  All that adds up to absolute, unequivocal, unshakable certainty that you have no STD; your GP is right.  I cannot comment on the skin rash component; if your GP can't diagnose it, ask for referral to a dermatologist.

The rest of this message is one I have posted in response to other questioners with chronic, unexplained genital symptoms. It may apply to you.

"It is a fact of life that human beings get various aches and pains. Out of the blue there is knee pain, a headache, abdominal discomfort, a stich in the side, tingling down a leg. Sometimes such problems are continuing or recurrent, yet no specific cause ever is found and clearly no important infection or disease is present.

Why should the genital area be any different? Not every symptom means disease. People with such symptoms of course should see a health care provider. But when a comprehensive evaluation comes up with no good explanation for genital symptoms, and if they persist after treatment of the potential infectious causes, it is wrong to assume a serious health problem. Just as some people have to learn to live with unexplained but benign headaches or abdominal pain, others have to live with unexplained genital symptoms.

Our genitals have a special place in our psyches, and unexplained discomfort can be harder to ignore than a painful joint or even a headache. But the principle holds. It's fine to look for harmless things that might help control symptoms. But potentially harmful treatments (e.g., repeated high doses of antibiotics, potent pain controllers) make no sense, and doctor-shopping (or internet shopping) for different answers generally is fruitless."

Good luck--  HHH, MD

[ncworriedone]

I just want to say thank you to Dr. Handsfield.  I also want to let those of you who like me are terrified that they have contracted herpes or some other std from someone that he is absolutely right.  When I first posted on this site I had so many symptoms I was convinced I had herpes despite having been to numerous doctors all of whom said I didn't.  Dr. Handsfield was the first to suggest to me that it might be anxiety, stress or depression.  At that time when I read his response I thought that can't be true this pain is terrible and its real, but it has now been 16 weeks since my last possible exposure and as it turns out he was right as I had a negative herpeselect test.  My symptoms haven't gone away completely as of yet, but most of them have gone.  I still occasionaly feel a tingling sensation in penis, especially at night, but seeing as I have had symptoms now for 4 months and 4 negative herpeselect tests I am certain that it is all mental.  The pain I felt at times was intense, worse than anything I had ever experienced before, but with some help from my pcp who gave me an antidepressant and some pills to help me sleep I am doing much better.  For those of you who are in the same situation I was in, I wish you the best and hope your situation turns out like mine.   Just remember the pain is real and can be severe, but that doesn't mean that you have a disease, your body just wants to do what your mind tells it.

[mjones02]

Thanks for your response. I wish I can convince myself that it's just random pains and aches, but unfortunately the symptopms I'm experiencing are real. The inflammation is severe when I'm under stress and burn-like blisters do develop, one always reappears in the same area on the head of the penis. Since all these complications started to happen after the oral sex incident, I can't help but think it's related to that. The last thing I want to do is pass an STD on to my girlfriend.

Thanks for all your help