Urethral itching

[kodanda]

I am married 43 years male. I had protected vaginal and unprotected oral with a CSW in July 2012 in massage parlour in Korea. Symptoms started 36 hours after this encounter ie constant foreskin burning. The foreskin burning was constant 24/7 until Sep 2013. After this the foreskin burning reduced considerably and had urethral itching constant 24/7 which is continuing till date. In Aug 2013, Prostate PSA was less than 0.3. Two different Urologists took prostate secretion and tested under microscope. One Urologist said I had infection and gave me antibiotcs. The itching in urethra did not reduce. The other urologist said my prostate secretion dont have infection.
Tested in Oct 2013 - E.Coli was positive on urethral swab and took Amoxyllin 1000mg for 1 week. Itching reduced. I was tested for all STDs which were negative. Serum test showed HSV 1 IgG is 3.75. HSV 2 IgG is 0.3. Now the problem is urethral orifice is burning/itching constantly. I put a flash light and could see white/yellow residue in urethral orifice. I dont have blisters or any symptoms. Two urologists in India said it is genital herpes. But the urologist in Koerea said it is not genital herpes.
1. Is this genital herpes ie herpetic urethritis?
2. Will HSV 1 have impact on my brain and cognitive abilities?
3. What is the percentage of HSV1 in India where I come from?

The urologist in Korea said 90% population are positive for hsv 1.  

[Edward W Hook, MD]

Welcome to the Forum.  I'll be happy to comment.  Your lab tests show that you have HSV-1.  That however does not mean that  the symptoms that you are describing are due to your HSV infection and in fact, in my opinion, your symptoms are not at all consistent with HSV of the penis/urethra.  Herpes infections do not cause continuous symptoms for more than three weeks, at the most and that occurs only in severe first episode HSV infections.  Symptoms such as urethral itching are typically more a manifestation of increased awareness of normal sensations, often because of anxiety or other reasons for focusing on the possibility of symptoms than due to demonstrable disease.  

The majority of persons in India have HSV-1 and the vast majority of those persons have oral herpes which they acquired in childhood.  I suspect that is the case for you.  

1. Is this genital herpes ie herpetic urethritis?
No, when persons have HSV urethritis, they typically have obvious, visible external genital lesions as well.

2. Will HSV 1 have impact on my brain and cognitive abilities?
Certainly not.

3. What is the percentage of HSV1 in India where I come from?
The data are limited but in one study over 90% of Indian men have antibodies  to HSV-1 as you do.  It is presumed that most of these infections are acquired in childhood.

I am not sure why you have the urethral itching that you describe.  I doubt that it was due to any infection that you acquired in the exposure you have described above.

EWH

[Edward W Hook, MD]

Open sores of the urethra, whether due to infection or repeated self examination atre typically irritated when urine contacts them.  I would have your doctor take a look.

No change in my advice or assessment.  Nothing more to say.  EWH

[kodanda]

There is a shallow ulcera t the urethral orifice which is not healing and is burning/itching daily intermittenly.

[Edward W Hook, MD]

There are no STIs which cause the sorts of abnormalities that you describe.  Again,, I suggest that you consider that that this may be an alteration of your perception.  Alternatively, you should continue to work with your urologist.  EWH

[kodanda]

It is slight burning in urethra orifice opening constant. At present when I mastrubate the penis head swollen slightly. Last year the whole penis swollen after mastrubation. Is it because of urethritis. I notice split stream in urination after midstream urination. In the beginning there is dual stream for a second then the stream becomes normal. During the middle to the end its dual. This is always.