Possibility of herpes?

[netship]

I am 39 year male , I had a protected intercourse with a female prostitute but unprotected oral sex. After a week I started to have first transparent discharge, which after few days changed to purulent yellowish and it was in big quantity. At the same time the urination was very painful. Medical practiotioner without doing test gave me based on my symptoms antibiotic for chlamydia, which a bit help but the discharge continued an smaller amount. After that I got for gonorrhea "diagnosis" 2 times Zinnat 1000 mg with a week pause between. The discharge ended but the pain in penis or in urethra and tingling feeling in the tip of the penis did not.
I went again- this time- for an experienced practioner, who made a swab and looked it under the microscope and told me that it is for sure not gonorrhea nor chlamydia. Gave me oitment for few days and wanted to see me again. In between, while being already desperate and sick of that tingling pinching pain in tip of my penis, I opened the end of urethra as much as I could and dropped there an antiseptic fluid (which is used to disinfect almost every bacteria, and kills HIV, HSV) . I did this treatment twice - result , there came visible two red not equally formed areas about 2 mm in diameter visible in the end of urethra. And time I visit the second time this doctor , there had came a whitish cover on top of them. He ordered me to use Zovirax oitment on that for few days. Then the 3rd visit and now was visible throug the white cover a group of very small red dots. Visually estimating , he said that 95 % sure this is herpetic infection, because of those red dots. He did not know about my usage of the antiseptic few days before...
So he prescribed me acyclovir in tablets for 5 days and after that seeing that the area starts clearing up for the second 5 days.  Then happened the unexpected, I masturbated , feeling that pain and tingling in my penis and of course ejaculated . I washed myself , went to bed and woke up few hours later finding out that the whole penis is all around red , having red very small blisters grouped together, reddish areas and under the foreskin liquid and foreskin before the tip of penis like balloon full of air.  The testicles or the bag of testicles got enlarged. Painful , burning sensation all the time. Additionally I started to get some groups of blisters in my hands, which are now retreating.

This took now few days to heal, and the healing started - maybe by accident when the acyclovir tablets ended now on Monday.

Now in my genital area there is the old skin renewing (dropping out) and also in the skin of testicles.  There were no blisters which came full of fluid (only the foreskin just behing the tip of penis) and there were no open sores.

During this time - the last few days - I had fewer and lower back pain which (back pain) still is continuing and it is worse in the night time but improving.

So, based on this story..could it be herpes or candidas? balanitis?

[H. Hunter Handsfield, M.D.]

You obviously started with some sort of urethritis--it could have been gonorrhea or NGU (but chlamydia was unlikely)--that later testing didn't show gonorrhea doesn't mean anything since you were treated before repeat testing was done.  You're now seeing a provider who you believe is pretty experienced, and that person thinks you have herpes, and the problem is clearing up on oral acyclovir--so most likely you do.

However, herpes (or any other STD) doesn't explain the skin changes you describe for your penis or scrotum, or your back pain, and probably not the blisters on your hands.  Only the penile lesions and painful urination can be attributed to herpes.  Perhaps a drug reaction, or allergy to the antiseptic, masturbation lubricant, or something else--but that's only a wild guess.  Follow up with your provider and discuss the other symptoms with him; or ask him whether you should see a dermatologist.

Good luck--  HHH, MD

[netship]

Thank You Doctor,

just one question still :

1/ can herpes start inside urethra and be there for weeks causing those symptoms (painful urination and discharge) and like in my case spread around when I masturbated and ejaculated? That of course was after 7 days of using acyclovir.

Thanks for answer still...

[netship]

One thing: I saw dermatologist yesterday and she said that for sure it is not herpes - but propably toxic reaction by using that antiseptic and in the beginning she said that I had gonorrhea but it's now cleared. The several antibiotics just eroded my urethra and that's why the tingling and itching in the tip of penis and possible yeast infection due antibiotics in urethra. This dermatologist was a young doctor, so I did not fully trust her, therefore I posted you that original question.

[H. Hunter Handsfield, M.D.]

The rash/irritation externally just doesn't sound at all like herpes.  By contrast, the intraurethral symptoms and the lesions in your urethral opening sounded a lot like it.  But I have no way to judge that versus an irritative reaction to the antiseptic you put in there (which wasn't smart, by the way).  Anyway, you're up against the limits of what any expert can determine by verbal description, and I'm not making a particular diagnosis either for or against herpes.

If you were my patient, I would do an HSV blood test now and, if negative for HSV-1, repeat it in a few weeks to see if it becomes positive.  (HSV-2 is much less likely from an oral exposure.)

HHH, MD

[HHH,MD]

I meant to add that when you had the white-covered intra-urethral lesions, the provider who suspected herpes should have done a culture or PCR test for the virus.  Since you don't mention that, I assume it wasn't done.  Too bad.  Now you need to rely on the somewhat less certain evidence that might come from blood tests.

HHH, MD

[netship]

Hi once again, I noticed still yesterday a couple of red dots inside urethra and whitish cover around. I went today to dermatologist and she said that it looks like herpes.

So, the first episode is over externally , but herpes is laying inside urethra....what should I do? Dermatologist said that not to take acyclovir anymore and heal externally and the urethra will clear up in two weeks. Is that true? Am I contagious?

Thanks.

[netship]

Previous questions were to HHH MD. Others can comment too...

[who_is_this]

What kind of "antiseptic" did you put into your urethra?  I'm wondering how caustic this was, plus you mentioned you opened your urethra as much as you could?  How, and with what?  You may have abraded it, then compounded the damage with the antiseptic.

[netship]

the antiseptic was the liquid (mainly glicerol 85 %), name is Octenisept, used by medical professionals to prepare for operation in the wound area. It kills all bacteria, viruses like HIV , HSV etc.  I think also that it caused lateral damage , but it does not explain "whitish yeast" inside urethra. I have heard that there has no been a case seen that yeast been found inside men's urethra. So that's for the hope, I think it must be herpes.

[netship]

I opened with my fingers, so opening only 5 millimeters. But I kept this way - opened , fullfilled with antiseptic and the penis head upwards for few minutes , the antiseptic inside urethra.

[H. Hunter Handsfield, M.D.]

The white color of the lesions means nothing.  Any mucosal ulcer can be covered by white (or whitish) exudate, like a canker sore in the mouth.  An ulceration due to herpes or to irritation from antiseptic would look more or less the same.

I don't know where you heard that yeasts haven't been found in men's urethras.  Yeasts are commonly present in and around people's genitals; they are part of humans' normal microbial flora in the skin, intestines, genitals, and elsewhere.  (When people develop "yeast infections" it isn't generally because they acquired a yeast from somewhere.  Rather it's some sort of change that results in overgrowth of the yeasts, or in the body's reaction to them.)  In any case, yeast is not likely a contributor to netship's problem.

HHH, MD

[MonthofHell]

D00d. I don't know about the urethral problem, but I can relate with the penis head glan redness. I haven't had discharge either, but I could say that for 7 months now I've had the most painful penis head. It's almost completely covered in red and I've tried the following (Status includeD)

Polysporin *felt like million dollars until discontinued usage*
Hydrocortisone .5% *did nothing*
Hydrocortisone .1% *started to work after a week. Again,    
after stopping, the paint/redness continued
Canestin *did nothing*
Monastat *absolely nothing*
Hydrocortisone .1% mixed with an antifungal cream *hydcrocortisone worked better when mixed with the antifungal because the antifungal is a thicker cream which takes longer to absorb. In all cases, the creams that did work, work best when you put it on and sit naked for a full hour.

Masturbation makes stuff more sensitive. TO me, in my books, more sensitive means more painful so I've been going through absolute hell. If it is eczema I will know in the winter because eczema gets worse in the winter apparently. I do believe that It is a great chance that I have balantis *Even though i'm OVERLY clean* or PSORIOSIS (psoriasis). I found a pic of some guy who has Psoriosis (psoriasis) on his penis, they look a lot like mine.... but 10x worse in redness/bumps. Hope I helped ease some tension... btw, I was painfully worried about herpes as well and all my symptoms got much worse afterward. After stressing and accepting what I have, things feel better, but are still tehre and VISIBLY obvious.

here are that guys psoriasis pics....
http://i42.photobucket.com/albums/e335/stevejackson/private/d007.jpg
http://i42.photobucket.com/albums/e335/stevejackson/private/d006.jpg
http://i42.photobucket.com/albums/e335/stevejackson/private/d005.jpg


If you want me to contact you to discuss this further... leave your email on here and we can discuss our symptom similarities. I can't leave mine, . . cause too many people know my email, lol.

[netship]

Thanks for the advise, I looked the pics, my "scarring" is much milder , it's like different shade of colour of the meatus. Of course the foreskin, the wrinkled part, just before the meatus is similarly reddish most of the time. In this part of the foreskin and in the shaft I have had horizontal thin wounds made like with paper cutter. When I have masturbated , the cuts have bled . The herpes lesions are always superficial, so at least those cuts are not herpes. My worry is those darker red areas on the meatus, which look like getting very tiny dots time to time.

[dave825]

A related discussion, Hand Job and herpes was started.

[Fermino]

A related discussion, Urethral sore was started.