NGU or Adenovirus?

[rboston]

Dr.,

About 4 weeks ago I had unprotected oral sex performed on me by someone other than my wife. About two weeks after my wife and I had intercourse in the shower but prior to, she masturbated me vigorously with some exfoliating soap and I felt a little tinge of pain during that.

Within a day or two I started feeling an irritation near the tip of my penis, which subsided considerably overnight. Over the next few days it felt as though my penis was cold, sometimes wet, and sometimes irritated which felt like a little tingling. There was never any discharge of any kind, no burning with urination or any other symptom other than what I described. Also, at the time I was battling a little cold, moderate sore throat and a few days before feeling the tingling sensation, I came down with conjunctivitis in one eye for which I received some drops and it cleared.

I also self treated with 8 days of Doxycycline, 100mg twice a day and Cipro for 3 days, twice a day. Prior to actually starting the Doxy, the symptoms seemed to subside entirely. I began to take Doxy anyway as a precaution and did finish the course. During the Doxy course I did feel a recurrence of the tingling sensation for a day (about day 4 of Doxy) but that went away within a day. I was symptom free for the remaining Doxy treatment and for about 3 days after I stopped. Last night I began feeling the slightly uncomfortable tingling feeling again at the tip of my penis. The cold that I've had has also persisted, which has consisted of some respiratory issues, including a cough and phlegm. My wife was treated with Doxy as well at the same time.

The tingling feeling that has now recurred comes and goes and is very subtle. The urethral opening may be slightly red, but doesn't look abnormal and I suspect it's always slightly red and I've just begun to take closer notice. My anxiety has been fairly heightened. Still no burning and no discharge and I'm wondering if this could be adenovirus?

Thanks.

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  The quick response to the central question asked in the title you selected, after reading the entire question, is:  Neither one.  Most likely you never had urethritis of any kind.

Adenovirus can be acquired by oral sex and causes a few percent of NGU cases, and the simultaneous occurrence of symptoms like an upper respiratory infection could go along with adenovirus.  But adenoviral infections generally clear up within 2 weeks, so even if that was an initial contributor, it is no longer a plausible explanation of continuing symptoms, either genital or respiratory.

NGU rarely if ever causes the sort of symptoms you describe, without penile discharge.  It's conceivable, but that's the main reason I suspect you never had urethritis.  Maybe a little chemical or physical irritation, but probably nothing more.  If you happened to have acquired a bacterial infection -- either NGU or gonorrhea -- the antbiotics you took would have cleared it up.  In any case, the subtle symptoms you describe now are not likely due to any infection at all -- especially given your self-awareness that the "redness" might not be different than the appearance of your penis over the years.

Bottom line:  Probably no STD at all; and if at the start there was a component of something acquired from the oral sex exposure, at this point you can be confident you have nothing that will ever harm you or a future sex partner.  Try to put your mind off all this, and I'll bet the residual symptoms will fade away.  Of course, if in doubt, see a health professional about it.

And if this sort of thing happens in the future, get professionally evaluated at the get-go, without self diagnosis or self treatment.

Regards--  HHH, MD

[H. Hunter Handsfield, M.D.]

Almost everybody with psychologically generated symptoms disbelieves the explanation, so your conviction about that doesn't sway my thinking.  All I can say is that your symptoms are typical for that.  And yes, they likely are compatible with a prostate gland problem or CPPS -- but those possibilities themselves overlap with stress, anxiety, etc as possible explanations.  In any case, it remains true that STDs don't typically cause the symptoms you describe -- and since this is stricly an STD forum (and not a genital symptoms forum), that's all I have to say about it.  If you remain concerned, you can keep visiting health care providers in a search for answers.  But if clear explanations don't emerge, at some point you would be wise to at least have a discussion with a primary care provider you trust about the possible contribution of psychological factors.

That will need to end this thread.  Take care.

[rboston]

Hi Dr.,

Sorry to come back around on this thread, but my symptoms continue to come and go. There have been no other exposures since treatment yet I continue to have the discomfort/irritation at the tip of my penis from time to time. I'm beginning to notice that it occurs more often when I'm seated for long periods of time at my desk when working. I'm beginning to wonder about prostatitis. At this point it's been 6 weeks since the oral exposure and about two weeks since finishing the cipro/doxy treatment. Still have not had any burning when urinating or discharge. I'm reading that prostatits, if bacteria related, can be stubborn and even though there is a lot of info on CPPS, I just can't imagine this sensation could actually be anxiety related?? I'm confident based on your last message this isn't STD related; I'm just getting a little frustrated.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.

The only symptom possibly due to such irritation was the initial "irritation" that "subsided overnight".  None of the rest of the symptoms is typical of any physical cause.

[rboston]

Thanks for the quick response Dr. Hansfield. I've spent a considerable amount of time on the forum the last couple of weeks and find the information and service invaluable. I am definitely self aware of the anxiety I've been experiencing and I do suspect that plays a part in being hyper vigilant about the sensations I've been feeling. I don't think it's entirely in my head but the reassurance is most helpful.

If my symptoms were the result of physical or chemical irritation, could this explain the recurring symptoms? If so, how long would it reasonably take to subside?

Thanks again for your quick response, I appreciate it.