scared and concerned whats wrong with me?

[dodgeman]

Dr.
I am very concerned on 7/28 I had a bachelor party for my wedding in las vegas, unfortunately i got very intoxicated and had oral sex and vaginal sex with the "pro". I know for a fact that i had a condom on but i also recall her rubbing some body lotion on the condom when we had vaginal intercourse. the next day i began to have a stinging sensation when i urinated. then i noticed i had to urinate more frequently than usuall. well by the end of the second day the urination was frequent and the tip of my penis started to constantly burn. when i came back home 4 days later the burning sensation was getting to be unbearable and urinating was non-stop. so tuesday i went to the er they did every test for std, as well as all blood work for std's the results came back neg for everything. the diag me with uretheritis and treated me with antibotics for clam, ghonn and trich. three days later i saw a follow up physician because the pain did not subside, actually the pain got worse my testicles felt like they were on fire and i have tenderness in my groin the pain on the test/groin are on the left side.she put me on floxacin for about 4 days and then did another swab test for clam, ghonn again negative trich test done (urine) also negative,i also had a ultrasound on my testicles which came back normal and a cat scan on my pelvic area which showed up normal except that my spleen was slightly enlarged. i was also tested for mono and came back negative. she changed my meds to levaquin 750mg, iv'e been on it for about 8 days now and then pain is still there not so much heat on the scrotom but still some burning from the urethra and tenderness in the left testicle and scrotom as well as the left groin area. My doc said she does not think that this was caused by a std she said i have nongonnocal no clam uretheritis probably caused by ecoli or enterococcus. I also saw a uroligist and he examined me and said take this detrol that whil help with the frequent urination and did a physical exam on my pelvic area and scrotum checked to see if i had a hernia and said no, come back in two weeks.yesterday while at work i had to urinate and after doing so my urethra started to burn very badly. I went to the er right after that and the doctor said he thinks i have hsv1/2 no sores are present on the genital area as well as there has never been any discharge from my urethra. He took blood for a hepres select test and i asked him to do a swab again for clam/ghonn. he also did a prostate ex and said my prostate felt normal. He prescribed me valtrex. I had a hiv test done two weeks after this incident and i came up negative. This doctor seem very sure that i have hsv1 or 2 and is the test going to detect that after only 18 days. I am scared...please tell me what you think. how could i have the burning symptoms so soon and it be hsv1/2.my wife is clean ive been with her for 7 years and she has had sex only with me.i just want his all to end so i can get on with my life, tnx

[H. Hunter Handsfield, M.D.]

I'm not going to be able to help much.  But fortunately, it sounds like you are now seeing a doctor who knows something about STDs (not that the first ones didn't).  The idea of HSV sounds like a fair possibility, given your symptoms--but you'll have to await the test results.

Another possibility is that your initial urethral pain was due to an irritation, not an infection, associated with the sexual encounter you describe.  In particular, if the condom contained the spermicide nonoxynol-9, that may be the only problem; N-9 can cause significant urethral irritation and pain.  Onset in under 24 hr ("the next day") is more suggestive of something like this than like an STD; with rare exceptions, no STD causes symptoms that fast.

Perhaps most important, the treatments you have had were more than adequate to eradiacate any STD.  So apart from the possibility of herpes, you can be 100% confident you don't have anything you can transmit to your wife.  So for now, try the valtrex and see if it controls your symptoms, and wait for the HSV blood test results.  It's a little early to be positive at 18 days, though, despite what the doctor said.  If your symptoms don't clear up on Valtrex, you can be certain it isn't herpes.  If they do and the initial (18 day) blood test is negative, get retested after 6-8 weeks.

Bottom line: If herpes doesn't pan out, you can safely have sex with your wife without putting her at risk.  Even if your symptoms persist, it doesn't necessarily mean an ongoing infection.  An immunologic/irratative reaction, or anxiety (or a combination of both) could be the only problem now, regardless of what started it off.

Good luck--  HHH, MD

[dodgeman]

doc if it is herpes how long would it take to see the symptoms go away with valtrex.

[MedTox]

I have the same symptoms as yours, please read above (Urethra Pain). Now I think this may be due to the nonoxynol-9 spermicide, we have that in common with the same exact symptoms. There has been lots of reports on how highly irritating this substance can be. If thats what it is, someone need to do something about it, they cant let a substance out there causing this much grief to people. What I dont understand is why wouldn it cause an irritation on the outside rather than on the Urethra itself ?  

[H. Hunter Handsfield, M.D.]

Herpes symptoms should start to improve 2-3 days after starting antiherpetic therapy and pain largely resolved after 4-5 days (although complete healing takes longer).

HHH, MD

[dodgeman]

doctor my only concern that this may not be herpes is that my doctor said one the symptoms came on to early and also its been almost three weeks and i have not had any outbreaks anywhere (penis, rectum, groin, buttocks) also would herpes first cause irritation of the urethra burning constantly, then a few days later heat sensation on the scrotom and tenderness in the left side of the groin and left testicle and the left epididymis. Thanks again for the response to the initial question.

[divo51]

A related discussion, divo51 was started.