tenderness at urethra

[bob101]

First off, let me just thank you for having this forum. You definitely have a way of easing people's anxieties. (including mine)

My problem is this, after receiving unprotected oral sex from a girl a couple of weeks back, the girl has subsequently tested negative for everything, (including herpes) I am still having issues with my penis. Specifically, i have no burning during urination, but after i have almost completed and squeeze my penis to get the rest of the urine out, i feel some mild pain. I am not sure if it just me pinching the urethra, but it usually lasts but a couple of seconds. What could be causing this? I tested for chlam, gonn, syphilis, all neg.


Secondly, I seem to have at least some type of tenderness on the meatus and the skin leading to the frenulum (i looked all over the internet for what this area is called, but could not find it.) It starts at the outer meatus and runs underneath my penis to the frenulum. Anyways, this area is still tender, usually upon rubbing against clothing, or sometimes to the touch. The first doctor I went to said to put hydrocort on it, but it still hasn't gone away. Second doc said that the steroid may be keeping it inflammed, said use neosporin. Still hasn't really gone away. Any ideas what may be causing this?  Should I just ignore it? Or is this just anxiety?  Is there anything else this could be?

[H. Hunter Handsfield, M.D.]

Well, I don't know if it's just anxiety; I'm not a great believer in purely psychogenic causes of pain.  But certainly anxiety can greatly magnify a symptom that would be present anyway, perhaps elevating it from barely perceptible and not apparently important.  But you are a better judge of your mentation and your body (and your personal level of body awareness) than I can be from a distance.  But since oral sex is such low risk, your tests were negative, and two providers haven't found anything wrong, I have to believe you don't have anything of importance.  Most likely your symptoms will just fade with time.

Good luck-- HHH, MD

[bob101]

Is there any chance this could be herpes still? I have noticed in the last two days that I have swollen lymph in my neck, but i have not been sleeping well or eating well since this encounter with the girl. So, I might be making myself sick. I am very nervous about all this...

[H. Hunter Handsfield, M.D.]

"Any chance?"  Probably; herpes is a highly variable disease.  But very unlikely as a cause of the ongoing symptoms you describe.  Conceivably neurogenic pain, due to herpes that has resolved but has left some neural irritation behind.  But even that is speculative.  You could get an HSV-1 HerpeSelect test.  Problem is that half the population is positive; a negative result would rule out herpes, but a positive wouldn't tell you anything one way or another.  (HSV-2 infection is virtually ruled out by the orogenital exposure.)

HHH, MD

[bob101]

So if my lymph nodes in my neck are the one affected, it points to HSV-1? not HSV-2? Moreover, I never actually kissed this girl so does that possibly rule out a reasoning for my lymph swelling in my neck? I have thought that my constant anxiety and nervousness (lack of sleep, not eating, ect) may also be a culprit in my lymph nodes swelling.

[H. Hunter Handsfield, M.D.]

A swollen lymph node in the neck could be due to herpes, but many things are much more likely.  Oral herpes is virtually never HSV-2, and your exposure was to a partner's mouth.  So if you acquired herpes during that exposure, it was HSV-1.  Fatigue and poor diet don't cause swollen lymph nodes.  But I can't say anything more about your diagnosis; you'll need to see a health care provider.

Good luck-- HHH, MD