Constant Urethritis

[elviratron]

Doctors:

I am a 30 year old man in good health except that I have constant pain inside my penis and sometimes on the outside as well.  This condition started a year ago, a week or two after I received oral sex from a sex worker.  My doctors have no idea what is wrong with me.  I have been operating under the assumption that my pain is caused by HSV-2 because I have a positive antibody test result.  That said, I have no clinical signs (e.g., visual lesions) and my pain is not marked by the traditional outbreak periods followed by longer periods of remission.  Rather, I have been experiencing constant urethral pain for the past 10 months.  I hope that you can help or point me to someone who can.  

As far as testing that has been conducted, I have tested negative for chlamydia, gonoreah, syphilis, hiv, and hsv-1.  As noted, I tested positive for HSV-2 (the type specific antibody value was 1.7, I think).  The HSV-2 culture swab test (sample taken from inside the urethra) was negative.      

I went to a number of doctors.  My primary care physician told me my condition beyond his ken, but he referred me to an infectious disease specialist, a urologist, and an oncologist (b/c I had a very low neutrophil count).  The infectious disease doctor said that he could not diagnose it as herpes because herpes produces "trademark lesions" and is episodic; whereas, I experience no visible lesions and my pain never goes away.  Instead, he suspected a persisitent bacterial infection of the prostate and put me on a long term antibiotic.  The urologist listened to my complaints and dismissed me rather curtly, indicating that there was nothing urologically wrong with me.  The oncologist said I didn't have leukemia (he ran blood scans and my neutrophils were fine).  

The pain began in October of last year.  I got terribly sick all of a sudden.  My legs lost all strength.  There was sharp shooting electric like pain in my thigh muscles.  I lost my appetite for 10 days and lost at least 25 pounds.  I sweat profusely, especially at night when I would soak my pillow and bed sheets; on the worst nights I could not sleep at all.  There was an intense pain inside my urethra.  Inside there were what appeared to be two very tiny red/purple dots.  I had swollen lymph nodes.  For a week, I quite literally felt that I would die.  During this time I could not acheive a full erection and even starting to get hard would cause intense pain.  When I eventually could achieve a full erection, ejaculation felt like shattering glass inside my penis.  Eventually, most symptoms went away, but the pain inside the penis continued.    

Since then, I have had almost constant pain in my penis.  More specifically, the pain seems to run three month courses.  It will begin with a vibrating feeling deep inside my penis as if something is exploding inside there.  This is not very painful, just quite alarming.  Then I will feel intense pain inside the urethra.  The visible area inside of my penis will be deep purple on the left and right sides and bright pink at the top and bottom edges (looking down at it).  This discoloration can come one day and go the next, only to come back a few days later.  Urination will be out of this world painful.  Currently, I can ejaculate some days, although it is sometimes painful.  Same thing as far as the erection itself is concerned; sex is usually painful but not unbearably so.  Sometimes the outside of the penis (either the tip or somewhere on the shaft) will hurt as well.  I sometimes can see an area of slight redness on the glans (looks like a splotch or a birthmark) or a band of redness on the shaft.  These visuals will go away in a day or so.  Towards the end of the three month period, the pain will recede to a manageble level where I can almost forget about it if I try.  Although the pain is by no means gone completely, this is basically heaven, which lasts a month or two before the vibrating begins anew, and I am in for another three months of exquisite pain.

I took a number of antibiotics early in the sickness, incuding short cycles of bactrum and cipro, respectively, followed by a three month cycle of doxy.  I have also been on valcyclovir for almost 7 months now.  I take 1g daily.  It has no perceivable effect on my condition, but I take it to reduce the risk of transmission to my gf.  I also take Tramadol for the pain, which is effective when the pain is minor, but really has very little effect when the pain is serious.      

I need help.  I have a rather high pain threshold (former military), but this pain is excruciating and never goes away.  I have had to radically alter my life as most physical activity irritates my already unbearable condition.  I have a desk job, but concentrating is difficult because the pain is so intense.  

Perhaps you have some experience with symptoms like these and you could give me some diagnosis insight?  Otherwise, perhaps you could tell me who to talk to in my area (Philadelphia) that might be able to help.  I really am at my wits end.  Any help you can offer would be deeply appreciated.  

Thanks,

John  

[Pete_123]

Did you ever get this sorted? My problems are very similar to yours, and was wondering if you ever found a solution?  Thanks, P.

[gracefromHHP]

your hsv2 igg is a very low positive and needs confirmed with additional testing. It's a good chance that it's a false positive so this is worthwhile doing.  A herpes WB is the best test to have done to confirm your status.   I'd stop the valtrex at this point since 1 - it isn't working and 2 - you don't want it to interfere with your test results.    

you are smack dab in the  middle of some of the best health care in the entire world - find a different urologist who will listen to you and take the time to do a proper evaluation on you without dismissing you like the one you saw seemed to have done.  it's not likely this is herpes related at all.

wish I could say oh this sounds like X but really there are many things that can cause chronic urethritis.   no relief from valtrex is just one more reason why herpes isn't the likely cause of this.