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Possibility of herpes in urethra of male??
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by BayouBoy85, Oct 22, 2008
Lets start off with about two and a half monthes ago I was treated for prostatitus, crazy for a 22 yr old male right??Three weeks ago to be exact I noticed a burning sensation in my urethra about 3/4" inside, I also noticed a little redness on the underneath side of my shaft right next to the head of my penis and redness on the tip of my head. Also I ejaculated once after noticing the syptoms and it felt like a razor blade cutting through my urethra. Also I noticed an increase in dribbling after I urinate and it feels like threre is constantly some type of liqiud sitting inside of my urthra just waiting to drip out and does occasionly. How can I know if this is caused by some type of herpes, is there any test that a doctor can perform directly on my urethra to tell me if I have hsv1 or hsv2 inside of my urethra???  Or could tis just be a yeast infection due to the medications from treating the prostatitus??

I am very concerned because I do not want to end up passing anything on to my girlfriend.
Answer:
239123_tn?1267651214
Let's start with the apparent diagnosis of prostatitis.  Your opening coment suggests you know it is rare in men your age.  Some doctors unfamiliar with STDs diagnose nongonococcal urethritis (NGU, and STD) as prostatitis or urinary tract infection -- and diagnosing prostatitis can be difficult, so even the conscientious and knowledgeable provider can be easily confused.

Herpes is an occasional cause of NGU (but not prostatitis); HSV is associated with 3-5% of NGU cases.  However, it seems unlikely in your case.  Most herpetic urethritis accompanies other evidence of genital herpes, i.e. penile blisters/sores.  It is typically much more painful than you describe (I have had a couple of patients over the years who described it as the worst pain they ever experienced, especially when urinating).  Finally, HSV symptoms generally clear up in 7-10 days, not 3+ weeks.  It is conceivable your initial infection was your first urethral HSV infection, and that your more recent symptoms represent a recurrent outbreak inside your urethra.  But for the reasons above, I doubt it.

In addition to herpes, there are other viruses that can cause NGU.  A few percent of cases are due to adenovirus -- normally a cold virus, but one that can be transmitted by oral sex.  But adenovirus would not recur -- so if that were the explanation, it would have to be a new infection, not related at all to the "prostatitis" 2 months earlier.

Finally, NGU itself -- especially when due to things other than chlamydia -- sometimes persists or recurs following treatment.  But when that happens, the main symptom is recurrence of mucus or pus from the penis, not just urethral pain.

There are 2 main kinds of tests for HSV ifnection.  If your provider agrees it is worth checking out, s/he could collect a swab sample from your urethra to directly test for the virus.  Second, you could have a blood test to look for antibodies, i.e. your body's immune response to the virus.  It takes a few weeks for HSV antibody tests to become positive, sometimes 3-4 months, so your provider might want to delay a blood test until then.  Half of all adults have positive tests for HSV-1, generally going back to an oral infection in childhood -- so a positive blood test for HSV-1 won't mean anything with respect to your genital symptoms.  

Yeast infections of the urethra are uncommon, even in men on antibiotics, and mostly painless.  That doesn't seem like a very likely possibility.

That's as far as this forum can go; obviously I cannot make a specific diagnosis.  I suggest you return to the doctor or clinic who managed the apparent prostatits and discuss these issues with him or her -- then follow that advice about further diagnostic tests and/or treatment.  But don't get your hopes up (or your worries up) about herpes as an explanation here.  I doubt that's the problem.

Finally, you should also follow your provider's advice about whether you still have anything that could harm your partner.  Most likely not; I doubt you have anything that will ever significant harm you or her.

I hope this helps.  Best wishes--  HHH, MD
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Member Comments (6)
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by BayouBoy85, Oct 22, 2008
The first time around, my doctor told me it was a bacterial infection that caused my prostate to become infected and was cleared up with antibiotics, he ran a urine analysis to be sure, so .....
239123_tn?1267651214
It is unsafe to second guess a provider who has directly examined someone, but this sounds even more like NGU and a rather typical scenario involving a doc not very familiar with STDs.

A clarification of my initial response:  Given the likelihood that the original problem was sexually acquired NGU, your sex partner(s) at that time need treatment.  That includes your current girlfriend, if you had sex with her before the initial antibiotic treatment.  In that case, you might need re-treatment yourself -- and that would also suggest the possibility that your new symptoms are due to reinfection because she wasn't treated.  If so, it would also be wise to (re)test both you and her for chlamydia and gonorrhea.

However, if you haven't had sex with her since you were treated, then my reply above still stands.
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by BayouBoy85, Oct 23, 2008
No, we have not been dating that long, but I did have protected sex( the condom broke though, so that kinda went f.u.b.a.r.) with another girl between the two infections, could this last response still apply and should she need to get checked??
239123_tn?1267651214
I gather you had received antibiotics before you had sex with either your current partner or the one with the broken condom incident.  If so, I see no need to go there.  That said, times of partner change are generally good opporunities for routine STD testing for common infections like gonorrhea, chlamydia, etc.  You might take the opportunity to tell your new partner you did that (without the details we have discussed) and suggest she might want to do so as well.  Properly done, that sort of discussion can actually help the evolution of a new, promising relationship by implying mutual caring about health.  But don't press, unless you have particular reason to believe your new partner is at high risk. She is not apparently at high risk from you.
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by BayouBoy85, Nov 03, 2008
So, I went and got a swab done for the inside of my urethra to check for HSV, the tests came back negative, adn the doxycycline seemed to be workingI had no pain and no other symptoms for about 1.5 weeks, then mmy the tubes leading from my left testicle to my penis started to hurt(felt like "blue balls" for about three days straight) then it went away and four days later I masturbated twice within a 24 hr peroid and the slight burning came back in my urethra. Could this possibly be just urethral stripping or what??