Can this be Genital Type-1 Herpes?

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I'm a male that had unprotected oral sex with a female.  About a week or two later I started to have a burning sensation in my penis and in my urethra.  I had a mild burn when I urinated and there were no blister oe lesions.  I went to the doctor and got tested for UTI, all STDs except for herpes and HIV.  He also gave me antibotic (antibiotic) for the infection.  The test came back negative.  About a month later tha pain came back.  I really started to get anxiety and depressed because of the situation.  I went to see a Urologist and and he gave a Herpesselect I and II test and a HIV test.  Everything came back negative except the HSV-1 test.    The Urologist told me that I probably got this in early childhood or in the past, but I don't remember ever having a cold sore. He also told me that my sysptoms did not sound like genital herpes. The irritation went away after two weeks.  A month later (currently) I been having a mild stinging sensation for three weeks. I've been so nervous hoping that this isn't genital herpes.  I took another Herpesselect I and II test with the Urologist.  The test came back with the same results and he said the the penis irritaion that I was having is not from herpes because the virus was not active at the time that he took the test.  He told me to stop stressing and it is not genital HSV-1. I've been seeing a phycologist about my situation.  He told me that the penis irritation is comming from anxiety and it's nothing but muscle spasms.  He told me that I didn't have to tell future partners about my situation and I can have children in the future.  I have five questions for you:

1.)Do my symptoms  sound like genital herpes type-1 or anxiety?
2.)Is it true that 60-90% of the US population has HSV-1? Do I have to tell my future partner I have HSV-1 (oral or genital)?
3.)Will I be able to have children in the future?
4.)It is easy to pass the virus with out blister?
5.) Should I take my phycologist's advise about this situation?

[Kevin Pho, MD]

To answer your questions:
1) It is possible, but atypical, for HSV-1 leading to genital herpes.  You may want to consider antibodies to IgM - which can indicate a more recent infection.  Although HSV-1 is normally related to oral herpes (i.e. cold sores), there are some cases where HSV-1 can lead to genital herpes.  Yes, anxiety can also lead to the symptoms.  

2) There is indeed a large proportion of the population that have HSV-1.

3) I do not see anything in your story that would preclude you from having children.

4) If there are active lesions/sores, then it is in its infectious stage.  Culturing the lesion is best done at this point.

5) I would ensure that an STD isn't present first (i.e. obtaining either a viral culture/Tzanck smear or an IgM to HSV-2) before attributing the symptoms to anxiety.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.comg

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