Not sure what it is?

About 4 monthes ago i had unprotected sex with a young girl. three days later i had bad pain that felt like it was in my urethra right under the head and i got a rash around my anus. i got tested 3 days after the pain started for Clymidia and herpes. i still had pain for 3 more weeks (just in the Urithra, the anal rash went away) so i got tested for herpes again and it still came out negative. i wasnt relieved still because it could take almost 12 weeks for herpes to show up. i still had pain for about 14 weeks so i got tested for herpes again.(it was a bloodtest) the results still came back negative. it has been 4 monthes now and i still have pain in my urethra. it gets worse after masterbation (masturbation) and sex and sometimes during urination. every once and a while i get numbness in my left foot but that goes on and off. i have never had open lesions or any surface abnormalities.  i have been treated for clamydia (chlamydia) and for urethritus, neither medications i took have helped. The pain in my penis starts to worsen over the day, but when i wake up in the morning, its not there, or not really bad at all. it just seems to act up when i play with it or after i pee or have sex.

1.) could this be herpes? or could it be something else?
2.) if it could be herpes, would the symptoms and pain last for
4 monthes without stopping?
3.) could this pain not even be related to an STD? could it be something else?
4.) did the anal rash have anything to do with my Urethral pain? or did they both just seem to happen at the same time?
5.) can herpes just happen in the Urethra with nonstop pain for 4 monthes?

                thanks

[H. Hunter Handsfield, M.D.]

Based on your symptoms and test results, it is unlikely an STD explains your symptoms.  However, you do not say whether you were evaluated for urethritis other than testing for gonorrhea and chlamydia, and conceivably you could have nongonococcal urethritis (NGU).  However, it is unlikely.

1) The symptoms do not sound at all like herpes.  It has to be "something else".

2) No, herpes would never cause persistent pain for 4 months.  Genital herpes symptoms always are intermittent, typically lasting a few days then several weeks with no symptoms at all, until the next outbreak.

3) I believe your symptoms are not due to any STD and probably are entirely unrelated to the sexual exposure you describe--unless they are due to anxiety over the event.

4) Anal symptoms rarely are due to STD in heterosexual men.  The most common anal area rashes are yeast infections and nonspecific irritation (pruritus ani) that may be due to feces contamination, hygiene, etc - and the sense of irritation (but not the rash itself) can be magnified by anxiety.

5) No; see no. 2.

Bottom line (no pun intended):  Follow up with your provider if your symptoms persist; or consider asking for referral to one who specializes in STD (or visit your local health department STD clinic).  Or just sit tight and let your symptoms fade away with time, which they almost certainly will do.  Almost certainly you have nothing that will harm your health in the long run, or that can harm a future sex partner.

Good luck--  HHH, MD

[Imdumb]

He does say he was tested for Chlamydia. Negative. I think that eliminates any doubt that you are right and he has no STD.

[flyer9dm]

Bob Trent,

The Dr. asks an interesting question about the evaluation for urethritis or NGU. Have you been evaluated at an STD clinic?

It is my understanding that a negative gram swab, no discharge and a negative Gonorrhea/Chlamydia culture would for sure rule out a bacterial STD of the urinary tract and most likely rule out any type of NGU (ureaplasma, etc). And since you were treated for gon/chl, the likelyhood that you have NGU should also be eliminated assuming that you used one of the recommended meds (z-pak,Doxy,ofloxacin,Levaquin).

By the way, i am NOT a Dr. so take this advice for what its worth. Someone please correct me if I give bad information.

That is all.

[H. Hunter Handsfield, M.D.]

imdumb:  I know he was tested for chlamydia, but that's not the same as being tested for NGU.

flyer, Bob:  Flyer is right about how NGU is diagnosed.  But pain alone, without discharge, rarely is due to urethritis; and NGU probably would have cleared up on its own long before now.

HHH, MD

[bob trent]

i went to see a doctor today and he said that if it was an std it could possibly be a wart in the urethra. could this possibly happen?? if so, what are the chances??


         thanks, bob