herpes? infection? worried...

[ron101114]

Hi Doctor-

I hope you are able to take the time to read this over. Even after reading all the information I can on STDs and herpes, I still have some doubts in my mind because of the nature of my symptoms.

About 4 days ago I visited a "massage parlour". I did go for a wash, massage, and "more"...specifically a handjob. I have done this once before, about 7 years ago, and other than guilt, I did not have any negative physical reactions. This time my penis may have been a bit red/irritated under the tip before I went. I took a long steam bath, was washed all over, then had a body rub. After about a 30 minute massage, the woman used lotion on my penis to stroke me until I climaxed, which was maybe a total of 2 minutes. She remained clothed, no other touching or sex acts took place. The worry started when I was there, because it seemed like a very dirty place. The women there were using the shower and towels to wash themselves. After my climax she left to get a "clean towel" and came back to clean me off. She used a lot of pressure and when she was done I also wiped my penis vigorously to clean up. I then got dressed and left.

About 10 minutes later I felt a slight burning sensation at the tip of my penis. I went and urinated immediately. The rest of that day, and since, I have felt a burning sensation at the tip of my penis. It is just about constant. Sometimes I will have 30 minutes of relief, but the pain always returns. I  have a raised skin under the tip of my penis, maybe 1mm wide and 10mm long that I have always had. I have also always had a slightly "puffy" area on one side of the opening of my penis. These are the places I feel the pain. I am circumcized.

When I examined myself later that day I noticed this area was very red, and irritated. I assumed it was just rubbed a bit raw, but a day later noticed a couple of small irritated cuts, with a raised border. Pinhead sized. The burning feeling got worse 2 days after, and I can't really tell if it is this area under the tip, or my urethra that hurts. It is painful pretty much all day long, and I notice it constantly. It is red and seems irritated. Sometimes worse, sometimes better. I have tried to drink lots and urinate frequently. It seems to relieve things a bit after I urinate. Taking ibuprofin doesnt seem to help, but I have taken a 200mg tablet every 4 hours for the past 4 days. I am worried sick with anxiety, and have barely slept. I am so concerned that I am going to see a doctor. I also wanted to get your opinion about what this might be. I know an exposure to herpes in what I described is extremely rare, but I can't help but think I might be that 1 in 1000 case of getting herpes from a "dirty" towel, especially since I think my penis may have been already raw. I have tried vaseline, cortizone cream, just leaving it dry, antibiotic ointment. No relief. It still burns.
What could be going on? Is a Urologist be the best doctor to see? Or another specialist?

Sincerely.

[H. Hunter Handsfield, M.D.]

Nobody ever caught genital herpes by hand-to-gential contact or by exposure to contaminated towels.  Your symptoms are more suggestive of physical or chemical irritation, nothing more.  But I cannot speculate as to the specifics.

ny general health care provider should be able to help; or see a dermatologist.  Or consider a visit to your local health department STD clinic for low cost, expert care.  (This is not code to indicate that I think you really have an STD; I do not.  But STD clinics are very experienced in evaluating genital rashes and other complaints.)  In general, urologists are not the best choice for skin problems of the genitals.

Good luck-- HHH, MD

[ron101114]

Dr. Handsfield-

Thanks for your reply. Again, I realize that you have repeated that advise with regards to hand-genital contact several times. I also think your credentials are respectible. I did not intend to just make you repeat yourself for my own peace of mind. However, there seems to be some opinion and (perhaps anecdotal) evidence out there that it is possible to contract Herpes indirectly. In my case, my worries were heightened by the fact that I believed I had had some irritation, or a raw area under the head of my penis at the time of my visit, and that this would put me at a higher risk of contracting a viral infection by contact. Had it just been just a burning feeling, or an inflammation, I might not have worried so much. But reading the plethora of information available on Herpes (both online, and Merck manual, etc.) there is definitely a wide range of opinions on what forms/stages an initial herpes outbreak might take. In my mind, I had experienced the inital "red bumps" and pain that would eventually turn into "painful blisters" after x-number of days, again, depending on materials referenced.

Based on your opinions what my presentation might be, I do feel somewhat relieved. Anxiety can play some not-so-wonderful tricks on the mind and body. As the saying goes...(something like...) "My life has been full of terrible tragedies, most of which never occurred."

I will seek medical advise to find out what is going on, and hopefully resolve the issue. The pain and discomfort is quite noticeable, and there is something happening "down there" that I would like to figure out. I will post a follow up and let you know what the outcome was, so any curiousities might be satisfied.

Sincerely.

[H. Hunter Handsfield, M.D.]

Why are you reaching so hard to hear the bad news instead of accepting the good?  Is it POSSIBLE that HSV could be so transmitted?  Of course; it's easy to imagine a scenario in which someone touched their own active herpes lesion (oral or genital) then massaged infected secretions into a partner's penis.  Is it PROBABLE?  No; never once in the medical literature has there been a report of genital herpes being acquired by hand to genital contact, and I never saw such a case in 30 years working in STD clinics.

And in any case, you do not describe any symptoms that sound like herpes.

HHH, MD

[ron101114]

Dr-  I can see why these types of questions are frustrating for you. I wasn't trying to be oblivious to the "good news", just explaining how my negative train of thought played such a role in my self-diagnosis, and worry. I don't doubt your conclusions about my issues! You are definitely an expert in the field, with a realistic approach to things. And Im not trying to be patronizing...hearing your confirmation really did help to put my mind at ease.

Mostly I wanted to point out my thought process, and how it prompted me to ask an already frequently asked question. Im sure others who have similar worries can relate to just how big a role anxiety plays in one's health. Like you said, theory and reality are two very different things. Browsing the internet can really freak you out sometimes, especially with the "filter of doubt" in place. =)

I have to wait until Thursday for my appointmet at a clinic but suspect by that time, hopefully, my signs/symptoms will have continued to improve on their own. While still noticeable, the burning is turning out to feel a bit better today than yesterday.

Take care.

[ron101114]

UPDATE: Hi Doctor Handsfield, and all. I wanted to post some more information that people might find helpful.

1. Planned Parenthood - If you are a guy, don't go there. LOL. Maybe another clinic would be better. Their staff was all female and they are more oriented to women than men. This is in Tampa, I am not trying to generalize. Other locations could be different. The Nurse Practicioner that examined me said she didn't think I had herpes or any other STD, but kept saying I should see a urologist to interpret the small red "sores" on my penis. She confessed she didn't examine very many males and wasnt an expert. We did a urine test to check for infection. The quick dip came up with an elevated PH level, and the full results I will get back today. Then I will go from there.

2. Testicular pain - I have been noticing an ache in my right testicle that has gotten worse over the past week. Now first let me say, I was diagnosed with a small epiditymal cyst on that teste one year ago, and I have had similar pains occasionally, but this seems worse. No point in speculating at this point.

3. Changes - This seems to be an up and down thing. 1 and 2 days after my "encounter" the burning sensation/redness of the external area/buring inside my urethra got worse. Stayed bad days 3 and 4. Worse day 5. Bit better day 6. Day 7 had my exam. Last night felt the best it had. For a period of hours it was not noticeable. Then I took a hot bath for some relief of my testicular discomfort. About 2 hours later the burning sensation was the WORST it had been ever. Outside area red and irritated. Put an ice cube on it for a while, which helped. Slept poorly. This morning though, it felt better again, but still hurt. Seems like the less I drink and urinate, the better it feels, and vice versa. And the hot bath REALLY irritated it.

4. Photo - I am posting a link to a photo...yes, its of my penis tip...a close up of the area. This is how it looked this morning, basically the same as it has for a week now. The small red "sores" are what I am worried about.

http://www.savefile.com/files/173996

So that is it. I will see what the urinalysis results are and proceed. I just want to get back to normal. =)

[ron101114]

ANOTHER UPDATE:

Not sure if anyone really reads these messages after the doctor has had a chance to respond. I imagine not many. But one of the things I did notice when searching/reading threads was that some I wished had more about what it turned out to be, or not be....not even for my own "use" but just to know that someone had some relief or answers for what might have been bothering them.

So...to update my "progress"...

Days 7 and 8 --- morning, things felt pretty normal. "Irritated" area not as red or noticeable. Testicular pain in Right teste increased, became more "dull" and aching, started to feel an ache in my thigh/groin area, and way up under my buttocks on same side, down inside of my leg sometimes. Centered almost right up on the pelvic bone beside my anus, under my butt check. Nights - YEOW!!!! Very intense burning develops in my urethra, when I pee it burns a bit, and seems to come with difficulty. Urine keeps dripping out of my penis for 5 minutes after I go, and gets the head wet, which irritates it. Sometimes the tip burns so bad it feels like a bee sting.  Aspirin doesnt help at all. Take 2 benadryl so I can sleep, and go to bed. Morning....it feels better.

Today (Day 9) --- Pain was so bad the last 2 nights, urologist appointment isn't until monday, so I go to a walk-in clinic. Urinalysis results show small amounts of bacteria, PH a bit elevated, trace blood/protein. I get a prescription for Doxycycline 100mg twice a day. Doc says if bacterial that should begin to relieve me within 1-2 days at the most.

No change in the "sores" -- first noticed them < 24 hours after the "massage" ...and they are still the same. they get red sometimes, and painful, other times the appear normal with no pain. They get better, then worse, then better, then really worse, then better, etc.........always something there though. I just try and keep the area clean and dry the best I can.

Burning in urethra starts in afternoon and stays until I go to bed. Slowly gets worse. Especially after I urinate.

So, that's it. I will take Antibiotics for the 10 day course, see the urologist on Monday and go from there.

Sincerely.

[Englishman]

Im guessing at eczema. Or truama that takes long to heal because of the location. Your follow up information is useful, I agee more forum users should do this. Good luck.

[Stoz]

I hope things get better for u... im also gettin a similer feeling on my penis.. Itching and red bumps. Not sure wat it is... but... i hope it gets better.. I Keep it clean and dry hoping it might get better... ive had it for about 2 weeks now... any ideas or advice?

[ron101114]

ANOTHER UPDATE: Maybe this can be useful to someone, someday...

It has now been 4 weeks since my massage parlor visit. The up and down nature of things has finally wound down, and although the area there is still a bit red and I can notice where the "sores" were, there is not longer any pain or issues with urination. My urologist did think I had Epidyimitis or Prosthatitis. I started on a course of Levoquine after the Doxycyxline, this is my second week on it. The pain in my testicle is just about gone. All STD tests were negative, I still want to wait another 6 or 8 weeks and get a Herpes test because it still seems like (even if it is a remote) possibility. If it was Herpes, it was not a typical case of it by any means, but things can vary so I would rather have the peace of mind. If it was infection, it took a long time to resolve.
As for excema...that is possible I guess. I have struggled with some dry/itchy skin around my groin area. I have been told it is ringworm/jockitch. It looks more like a patch of skin I had on my elbow years ago that they said was psoriasis/excema, that resolved on its own. So who knows.
I think by the time I get my Herpes test this will no longer allow me to post to, so the results will be unknown to future readers of this thread. Maybe it has been some help, at least it describes my experience and if anyone can benefit from that I hope so. I know I have learned a lot as a result of this, and my life is changed for the better in some ways even.
I sincerely wish the best for anyone struggling with mysterious health issues of any kind. They can be incredibly worrying, discouraging, and cause much anxiety. Just try and keep things in perspective, and deal with things the best you can as the situation develops. Seek professional medical help, and make lifestyle changes. Don't forget that anxiety and regret you felt. Learn from it, and grow from it.
-Ron