Persistent Irritated & Inflamed Meatus

[user0555]

Hi,
I posted this in another forum but would also like a doctor's advice. A picture is here:
http://www.medhelp.org/posts/Urology/Persistent-Inflamed--Irritated-Meatus/show/1217614

In late Dec I received a rough unprotected handjob from a sex worker.  During it, she reached to her anus to get lube that was put there earlier and then rubbed my penis with it. She rubbed my tip with her thumb in a circular pattern pretty intensely. After I noticed the meatus looked as if there were two pursed lips instead of a straight slit as before. I had no other symptoms.

In Feb, some irritation & inflammation started one day. The intensity varies but its worst moments, it's very pink and burns slightly when I pee. The size of the pursed lips also vary. There are sometimes very small bumps that disappear within a couple days along with the redness. My urethra appears to be always slightly open, revealing  the sensitive wet part of my urethra. I've also noticed more discharge than usual from my penis. It could be precum - it's clear, no scent, and has consistency of mucus. I also notice that after peeing, my penis drips more than usual.

Wearing boxers and walking aggravates it as the underwear rubs against my penis. The symptoms don’t resemble herpes or genital warts and doctors I have seen agree and dismissed the possibility of either. I was tested in Feb for HIV, syphilis, hepatitis B, gonorrhea, and chlamydia, all came out negative. I also had two urine tests that came out normal.

The dermatologist had me soak my penis in warm water with sodium bicarbonate 2x/day. The urologist I saw in March prescribed a cream that contains Gentamicin, Betamethasone, & Miconazole, which is supposed to clear any yeast or fungus infection.  Neither treatment helped.

Could it be due to an STD that I wasn't tested for? Could it be an infection from the bacteria from the sex worker’s anus? Or possibly due solely to physical trauma? Any other tests I should have done?

Thanks so much in advance.

[H. Hunter Handsfield, M.D.]

In theory, the STDs youmention can be transmitted by hand-genital contact. But it is very rare.  In 30+ years in a busy STD clinic, not once have I seen a patient with herpes or warts who had not had insertive intercourse.  So yes, there might be "some instances" of it -- but too rare to worry about.  And in any case, your sympoms do not suggest either of these problems.  Finally, any dermatologist would easiy recognize either one.  All things considered, an STD simply isn't a plausible explanation for your penile problem.

[user0555]

Hi, Thanks very much for the response. You have greatly assuaged any of my fears of STDs and I found the link you posted very insightful.

However, I was always under the impression that certain STDs, such as genital herpes or genital warts, could be transferred through hand-genital or genital-genital contact particularly if lesions are present because there is a higher probability that the person is shedding the virus. I've also heard this about sharing drinks with someone who has oral herpes and has sores present.

Have I been misinformed or are there some instances when hand-gential or genital-gential contact could put someone at risk?

Thanks very much

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  I would like to help, but I doubt I can do so -- except to reassure you that no STD is likely to be responsible for this.

On this forum we don't examine posted photos. In our view it comes too close to practicing medicine from a distance.  But I doubt it makes any difference my assessment.

STDs are not transmitted by hand-genital contact.  Here is a thread that explains the biology of STD transmission.  Start reading with the follow-up comment dated 12/14/09.  You should find it reassuring.  http://www.medhelp.org/posts/show/1119533

Whether this started with some sort of physical irritation, perhaps not related at all to the hand-job expousre you describe.  Scant amounts of clear mucus in the urethra usually are exactly what you describe, pre-ejaculate secretions.  Just as for any skin problem anywhere on the body, some genital inflammatory symptoms have no known explanation.  But there is no known risk to your health in the long run or to that of any current or future sex partner.  My advice is to continue to follow your dermatologist's advice.  Most likely the problem will fade over time.

Regards-- HHH, MD