Burning in urethra

[Charlotte12345]

I had unprotected insertive vaginal intercourse with a woman 11 days ago.  Approximately 9 days post-exposure, I began experiencing an urge to urinate frequently.  The next day(10 days post exposure) the urge to urinate developed into a persistent burning sensation in my urethra (approximately the last inch or so near the urethral opening).  Day 11 now, and the burning sensation inside urethra persists.  

Other notes:
- While my urethra has a persistent burning sensation, urinating itself does not burn
- No visible lesions on my penis or groin area
- No discharge whatsoever
- burning sensation varies...at times can be bad....other times, not bad at all

I had met with my family physician on day 10 because of the burning and he prescribed Cipro for 5 days suspecting it could be a minor bacterial cause like a common UTI.  I tested negative for both gonorrhea and chlamydia.

My question, and concern, is if this could possible be HSV-2?  I have read it is possible to have lesions on the inside of one's urinary tract, but have been told that would definitely coincide with discharge and very painful urination, which I am not experiencing.  I asked my family physician the same question and he said he has seen a lot of genital herpes outbreaks, and never has he seen one inside the urinary tract.

That said, I would appreciate another opinion.  Thanks, in advance!

[Edward W Hook, MD]

Yes, I have said that earlier  No further questions please  EWH

[Charlotte12345]

Will the antibiotiocs clear the infection?  Any issues once the antibiotic regimen is completed?

[Edward W Hook, MD]

The test for NGU is to look for white blood cells on a microscope slide of a urethral specimen or in the urine.  There is no way for you to diagnose it after the fact now that you've been treated however.  EWH

[Charlotte12345]

Thanks for your response.  Is there any definitive test to diagnose whether it is NGU or not?

[Edward W Hook, MD]

The problems you describe are classical for not only gonorrhea and chlamydia (which you now know you don't have) but also nongonococcal (NGU) urethritis caused by organisms other than chlamydia.  This is what I would treat you for and, without meaning to cause problems between you and your doctor, the recommended therapy for this problem is either doxycycline, 1000 mg twice daily for 7 days or a single 1.0 gram dose of azithromycin.  Your partner should also be treated with the same medication, in order to protect you both.  These infections are often asymptomatic in women but leaves them at risk for more serious problems if untreated.

As for herpes, symptoms like this can be seen with first episode herpes but typically also have external lesions present as well.  So the answer to "could it happen?" is yes, but the probability is very, very low.  I think you may have had NGU.  EWH