Unknown Problem -- Tingling in Scrotum area

[jonagold69]

For 6 months I’ve had on & off tingling in the scrotum/testicle area. It started while in Central America--a few days after I had protected sex (condom & cleaned self with alcohol wipes afterwards) with a woman. I assumed it must have been an STD or fungal infection. Of course, I also had been more than a month in several counties, in places hotter than I’m accustomed to, different standards of hygiene, etc.

I used a fungal cream for 2 weeks to no avail. The tingling was such that I didn’t notice it throughout the day or maybe on some days not at all. I would say it lasted 4-6 weeks before I forgot about it (I was home then). It later returned for 1-2 weeks & that’s when I feared I might have an STD. Note: I never had leakage nor blisters & my health seemed normal. The testicles might be slightly redder during these periods, but I’m not convinced of that yet.

I went to a clinic and was given urine tests for chlamydia & gonorrhea. At the time I was planning to travel to South America. Since the nurse suspected chlamydia she offered me the liquid 7-day antibiotic. I took it and 10 days later was told both tests were negative. (I still experienced the tingling during the first few days of the antiobiotic; then didn’t notice it, though it returned around the time I got the results.) The nurse this time was different and suggested I see a urologist (suspecting a male-specific problem), but was unable to arrange an appointment before my trip. She also told me the tests were highly accurate whereas the first nurse had told me they were 80% accurate.

While in a well-educated region of Brazil, the tingling returned. I went to a urologist—highly recommended by someone I know there. The urologist spoke with me at length, checked me over, and concluded I may have had something but didn’t believe I currently had anything. He told me sometimes symptoms persist even after treatment. He also told me that urine tests are not highly accurate; and that there are other tests that could have better told me whether or not I had chlamydia or gonorrhea.

So, here I am once again with mild symptoms (first time cold outside). I just started tracking the symptoms because it seems to me that after the lengthy initial period, there have been 3 recurrences about 4-5 weeks apart and lasting 1-2 weeks. That periodicity should be suspect as I’m only roughly basing it on memory. Also, I had noticed a web posting where someone had tingling & feared herpes but later was told a spine issue was probably referring the tingling. I’ve long had two issues—an old foot injury that refers discomfort to my left hip and sometimes lower spine area. As well, excessive computer use leaves me sometimes with tightness in the upper spine/neck area. I don’t know if either or these could be related to the tingling.

So, I’m not sure what to make of this. I’m also curious to know the accuracy of the tests and to know whether or not symptoms can sometimes linger after treatment.

[H. Hunter Handsfield, M.D.]

"Tingling" of the scrotum, or anywhere in the genital area, without other symptoms, is not a symptom of any STD, including herpes.  If you also had overt blisters or sores that followed the tingling, I would be conerned about herpes, but that seems very unlikely.  Certainly I would not have suspected gonorrhea or chlamydia, but in any case the negative tests rule out those possibilities.  (The tests are close to 100% reliable, not 80%.)  And you have been assured by apparently knowledgeable health care providers that you have no STD.  For all those reasons, I also am quite certain that no STD is (or was) the explanation.

Good luck--  HHH

[ryn21]

Honestly, with the assurance of testing I doubt you have an STD.  Sounds more like eczema or a similar condition.  Have you tried applying Cortizone cream to the area?  That may be what it calls for.  Alcohol would most certainly irritate the area, making the condition worse.  I would say visit a refutable derm or try applying Cortizone cream to the area.

[sparkeler]

Something may be going on, but it isn't an std.  Tingeling isn't a sign of anything sexually transmitted.

[apollo13]

Doc, Are you saying that prodrome symptoms only appear in conjunction with a symptomatic outbreak? Another STD specialist has stated that prodrome symptoms (burning, tingling, stinging, etc.) may be a herpes outbreak that does not break the skin surface because of a healthy immune system. Thoughts?

[H. Hunter Handsfield, M.D.]

What you say is true, but it doesn't apply to all tingling or similar symptoms.  If someone has localized (always unilateral) tingling or other neuropathic symptoms followed typical recurrent herpes (unilateral, clustered vesicles/pustules/ucers etc) that happens say 3-4 times a year, and also has some periods of similar tingling without lesions, s/he probably is having aborted HSV outbreaks.  (This has nothing to do with the health of the immune system, however.)  But I have never seen a patient whose only symptoms were prodrome without ever having a visible outbreak; and I haven't seen anybody with prodrome symptoms limited to the scrotum.  That doesn't mean it can't happen, but it is quite clear that johnagold69 isn't having HSV prodrome.

HHH, MD