Irritation and bleeding on penis head

[jason_x]

Almost two months ago I experienced what felt like a very severe UTI, coupled with extreme sensitivity and some redness on my penis head. I noticed a couple of irritated areas on the rim of my penis head, as well as a feeling of irritation at the opening of my urethra and some burning AFTER urination and became concerned I had herpes. I was especially concerned because I had received unprotected oral sex from a prostitute about one month earlier and had entered a new relationship not long after. I went to a local Planned Parenthood and was told I didn't have herpes, the main red spot was just an irritation and that I probably had epididymitis. Tests for gonorrhea and chlamydia came back negative. I went on antibiotics for a week.

All seemed well, and then I began getting serious rawness on my groin and the side of my penis shaft. It felt chafed all the time. The most prominent irritated spot did not go away, and I began to feel a stinging all around my penis head, especially on the underside. I began to use hydrocortisone, and that very quickly began to work - irritation almost totally subsided in a matter of days. I was feeling pretty good.

Then yesterday I urinated and used a piece of toilet paper to clean myself off. I noticed there was blood on the paper. There was no blood in the urine in the bowl. I couldn't identify a cut or sore and the bleeding ended very quickly. It has not bled again.

I have made another Planned Parenthood appointment, but they cannot see me for a week and change. I am hoping you can shed some light on the situation and advise whether you think I should wait for the appointment or try to walk in at the local center immediately.

[jason_x]

Doc,

I believe the epididymitis diagnosis was brought on by a transient and continuing aching in my left testicle. I thought it was minor, but the clinician was very interested in it. The aching - which could be best described as a one sided sort of 'blue balls' - continues.

[Sparko92]

A related discussion, Penis bleed was started.

[tiana2010]

I have red bumps on my penis n I was takin a bath n my ole lady was playin w/my pines n it started to bleed wat does that mean?????

[H. Hunter Handsfield, M.D.]

It seems unlikely anything serious is going on.  Probably safe to wait.

[jason_x]

Thanks, doc.

I am currently in a sexually active relationship. My partner has shown no signs of anything. Should I wait for the PP appointment or try to get someone to see me ASAP?

[H. Hunter Handsfield, M.D.]

Although I don't like second guessing a clinician who actually has examined someone, this doesn't sound like epididymitis.  Your own thought about that as a minor problem sounds right to me.

[H. Hunter Handsfield, M.D.]

UTIs are rare in healthy younger men without underlying disease of the urinary tract, like a prostate problem, congenital bladder anomaly, etc--and those are rare.  I agree that UTI-like symptoms, especially "severe" ones (like prominent pain when urinating), in combination with external penile irritation, suggests herpes.  (But one exception to my comment about UTI:  if you were the insertive partner in anal sex, you could have acquired a UTI that way.)

On the other hand, you provide pretty strong evidence against herpes.  The incubation period of 1 month was too long (normally only a few days); simple "redness" of the penis and a "red spot" (not a blister or open sore) isn't likely to be herpes; and an experienced clinician didn't think the problem looked like herpes.  Further, herpes doesn't cause "rawness" or other rash in the groin, and herpes does not respond to hydrocortisone or other steriod creams.  On top of all that, herpes lesions don't bleed.

I doubt you have any persisting STD at this point, although it is possible it all started with nongonococcal urethritis (NGU), or chlamydia or gonorrhea that was missed by the lab test.  I am a little puzzled at the apparent diagnosis of epididymitis and the bleeding episode.  Despite your initial symptoms, I am quite certain herpes does not explain any of the things you describe.  You are wise to follow-up at Planned Parenthood.

Good luck---  HHH, MD