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Rectal herpes or something else?

I have had on and off severe rectal pain and associated tightness in my sit bones and hamstrings for 15 years. It can go on for many, many months at a time.  I am positive for HSV 2 on my penis and have been for 35 years.

The rectal pain started as extreme pain in my rectum a few days after my wife licked my rectal area.  She did so after performing oral sex on me at a time when I had no outbreaks or symptoms on my penis.  I suspected that she may have transferred the herpes from my penis to my anus with her lips or saliva or perhaps that she herself had an oral herpes sore, although I did not see one. I had some swabs done on my anus by dermatologist with no HSV found about a month later.  I sometimes have blood when I wipe but not sure why.

It seems to me that clearly the pudendal nerve is involved in my rectal pain but I am not sure if it is some sort of neuralgia caused by the herpes virus traveling to my rectum or some nerve compression or other issue with the pudendal nerve.  It seems too coincidental to me that this rectal pain started after the only time I have ever had licking and kissing done on my anus.  

My question is whether or not what I describe can be rectal herpes and how can I confirm it or what can I do?  It is really painful to sit, although when I wake up in the morning I feel OK, the pain starts after I get up.  My hamstrings and sit bones are also tight.  

Appreciate any feedback or suggestions for next steps.  If it is herpes, I am worried that if I have an ablation done on the pudendal nerve for pain relief, that could be a really bad idea.  The rectal pain is relentless. Thanks.
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207091 tn?1337709493
You already had herpes in your anal area before the lick. Herpes infects nerve groups, and genital herpes infects the sacral ganglia. This affects the entire area covered by boxer shorts. At any time, you could have gotten outbreaks on or around your anus.

My guess is that you have a prostate issue - either inflammation or an infection, a pinched nerve, maybe even inflamed discs. I'd urge you to see your doctor for a prostate exam, urine testing, some imaging of your scrotum and back, if you haven't already done that. Who's decided that an ablation is necessary? Have they ruled out every thing else?
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