Concerned about Possible Genital Warts

[thetemp3]

Last month I had protected sex, oral and vaginal, with a partner with a promiscuous sexual history. 12 hours afterwards I experienced moderate pain in my genitals, next day had subsided somewhat, and since has varied between almost nothing to a "rug burn" sensation.

5 days later I went in to a clinic for STD testing, negative for HIV, syph, gonorrhea and clap. The doctor prescribed fungal cream just in case, mix clotrimazole and a steroid. Used this for 1 week, during which symptoms lessened. After 1 week saw my general practitioner, who saw no signs of infection but recommended that I use the cream for another week to be safe.

5 days after this (17 after encounter) I noticed what looked like an inflamed red lump on the tip of my penis, alongside the meatus, after a masturbation session. Went back to my general practitioner 2 two days later, by that point the lump had subsided considerably, although it was still present. The doctor performed a genital inspection, saw no problems. At this point I was on the last day of the clotrimazole treatment, and chalked the lump up to irritation from the cream.

Itching had not subsided, and the lump remained present. Tested for syph, gonorrhea and clap again, and inquired about the likelihood of a herpes infection. About 34 days after the encounter. Tests negative again, no signs of herpes. I pointed out the lump, doctor said it might be a genital wart, but that it was small and in an unusual location. She advised that I keep an eye on it in case it spread.

2 days ago (50 days after encounter), I noticed that the original lump again appeared swollen and red, and that a second lump had appeared on the other side of the meatus, also swollen and red. Both lumps reduced in size after a night's sleep, and since then have been barely visible; however, concerned that they might be genital warts.

I would like to know if I am being overly paranoid, or if there is any other condition that would be a more likely cause for my symptoms.

[H. Hunter Handsfield, M.D.]

A doctor's examination is much more reliable than anything I could say based on a written description.  Since your GP thinks they aren't warts, that also is my opinion.  In any case, a wart cannot change size overnight.  Since the lumpos now are 'barely visible', it seems the problem is going away, so I suggest just forgetting about them.  But if the spots persist or you remain concerned, tell your GP you want another opinion, maybe from a dermatologist. Or visit your local STD or GUM clinic.

By the way, it sounds like you are overreacting in general to the sexual exposure you describe.  Your genital pain 12 hours later could not be an STD or any other infection from that event; no STD can cause symptoms in under 2-3 days, and the ongoing symptoms you describe are not caused by any known STD.  

Good luck--  HHH, MD