A question about herpes.

[toutajan]

Here's my dilemma.  I've been having symptoms since last November, I posted for this before and despite seeing multiple docs haven't had any relief.  The symptoms are a painful burning feeling at the tip of my penis, the meatus, and slightly in and around the opening of my urethra.  Sometimes in addition to the redness it will swell up slightly.  I've never noticed any blisters or sores, no hard lumps, no pus, no discharge.  I've had repeated tests for hiv, syphillus, chlamydia, and gonorrhea, as well as a swab test for HSV 1 and 2, and HPV.  All of these tests have been negative for any diseases.  Despite my multiple negative tests, my docs have administered a variety of antibiotic regimens, including amoxicillin, erythromycin, ciprofloxacin and metronidazole and months of doxycylcine.  The only thing that seems to help is ibuprofen.

I've also been to a urologist who thought my problem might potentially be prostatitus or prostadynia, or possibly interstitial cystitis for which he prescribed a regimen of Prosed DS and Uroxatral.  All treatments have failed to provide any significant relief.  As a last ditch effort today he prescribed acyclovir as a clinical trial, being that we've tried everything else and I've not had any relief.  If this doesn't work he's going to send me to an infections disease specialist.

With all that background, I'm sure you're wondering why I'm posting a question at all...It's about the possibility of herpes.  Does this seem like herpes?  And with the acyclovir, assuming this is herpes, how long before I should expect improvement in my symptoms?  I've read the swab tests for HSV can provide a false negative if the cell specimens obtained don't contain the virus, how often do you see false negatives from this test?  

I've also seen other posts on this forum similar to mine, and my urologist said that he's seen this before.  He said it usually just resolves as mysteriously as it shows up.  What is your experience with this?  

[Edward W Hook, MD]

I agree with your urologist that when patients have symptoms such as yours we often pursue them vigorously without any good result and then they spontaneously go away with a variable amount of time.  If your discomfort is primarily external on the skin of your penis, it is unlikely that it is prostadynia or prostatitis.  

There is nothing in what you describe to suggest that his is herpes.  In fact your negative lab tests, the duration of your symptoms and your failure to respond to antiviral therapy all pretty much rule out the possibility of herpes.  while you are correct that swab tests (culture mostly) for HSV can be false negative, that is not an issue for you.  All of the other evidence fails to support the possibility of HSV.

My advice.  Stop taking medications.,  You have proven they haven't worked and to keep taking them is just asking for a side effect.  Ride it out.  This is not an STD.  Good luck.  EWH

[Edward W Hook, MD]

Sadly, this is not herpes.  If it were, you would improve after just 2-3 days.  EWH

[toutajan]

I doubt that this will change your opinion but I just wanted to clarify that I just started the anti-virals today, we've yet to determine if they're effective.  

Part of my question was if you could give me an idea of how long it might take, assuming they were effective, for them to have an effect on this condition?