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Urology  (Expert Forum)
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confusion over herpes
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

confusion over herpes

by Webinski, Jul 24, 2003 12:00AM
After reading so much about herpes this past week I cannot make heads or tails of my symptoms and how they figure into the probability that I may have HSV2.  I have many small red bumps on my penis which do not fit a clustered pattern (they're pretty spread out).  They have been present for 4 days and seem to be almost cleared up.  They do have small circular scabs in the middle.  They sprung up after 3 sessions of very rough unprotected sex and did not first appear as blisters.  This is the first time I've had them.  Have been with girlfriend for 6 months monagamously
1. What is your gut reaction to these symptoms doc?  
2. Please try to shed some light on the percentage of people with herpes who break out once or less than once a year.  Some sources claim that 80% breakout at least a few times a year while other sources seem to indicate that its more likely to be asymptomatic for years.
3.  Have you heard of the cells or natural bumps along the shaft of a penis getting iritated and blistering from rough sex?
4.  Girlfriend has shown no symptoms but I ran a triathalon after the sex and was wearing extremely tight pants with padding in the crotch.  Is this worth mentioning or am I grasping for straws?

by Kevin Pho, MD, Jul 26, 2003 12:00AM
Hello - thanks for asking your question.

Without examining you, it would be impossible to say way you have.  

1) Herpes, syphillis or chancroid are all possibilities for genital lesions.  If there is confusion as to whether this is herpes or not, you can consider a herpes culture, Tzanck smears or blood tests.

2) The frequency of recurrence depends on the severity of the initial infection.  Thus, both numbers you quoted above may be correct.  The mean duration of lesions is generally shorter (10 days compared to 19) and systemic symptoms infrequent; keep in mind that 25 percent of recurrent episodes are asymptomatic.

3) It is certainly possible to obtain a dermatitis or exacerbated a fungal infection from rough sex.  To be sure, I would be seen by your personal physician or a dermatologist.

4) I cannot think of any disease offhand that may be related to this.  Again, a referral to a dermatologist for further evaluation would be the most comprehensive course.  

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.

Thanks,
Kevin, M.D.
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