Herpes? Painful urination

[Mikec1976]

Thank you dr for replying to my last post 4 days ago. I am still in very bad pain every time I pee. My penile opening is still inflamed and does not look normal. It is not terrible butt he urologist pointed it out. He asked if I ever had herpes. He did a clymidia gonnoria test to be sure and that came back negative. Still waiting on herpes and syphilis test.  I had unprotected sex outside my relationship a few weeks ago. 5 days after that the painful urinating started and I have only ejacculated once sense and it was very painful. The urologist looked up in my urethra and only saw irritation at top penis. Nothing major he said. He prescribed valor ex to be sure and I have been on antibiotics for 11 days now. Sometimes when I pee my stream shoots sideways. Most of time it is straight. Only relief I have is drinking tons of water and that helps some when I urinate. I had blood work done and nothing looked wrong other than my monocytes were at 20 so kind of high. I am frustrated and stressed about this. I am a very healthy 35 year old who works out 5 times a week. I am a former athlete and I am worried about fixing this so I can move forward. I am not getting good answers from urologist. I feel he is guessing and not very helpful so far. Questions I have is is this herpes maybe or maybe wart inside my opening?  What else could it be? How long could this last? I cannot keep guessing and wondering. I never have unprotected sex lie that and now I am paying for it. Regardless I now want to resolve the situation. Thank you!!

[Edward W Hook, MD]

I think you need to wait this out. Finsih your medications. The fact that you are improving is a good sign.  I still do not feel that STIs aof any sort are likely. EWH

[Mikec1976]

Hi doctor. This will be my last post. I got my test results back and I am negative for herpes. I had my unprotected sexual encounter 2 1/2 weeks before the test so this test may not be accurate. My urologist today accepted the test and said he did not want to do a biopsy if the swollen penile meatus because it is a terrible place to biopsy. He thinks could be something other than herpes but he is not sure. I am still taking valtrex and antibiotic. It hurts less to urinate but pain is still there. If I drink tons of water it does not sting at all or just a little. The sudden onset of the painful urinating and swollen penile opening makes me suspect herpes every though test was negative. So gonorrea, chlymidia syphilis and herpes test all negative.  Any thoughts on all this would be appreciated. It seems you have more knowledge than doctors I have seen.  Thanks in advance.  

[Edward W Hook, MD]

Welcome back to the Forum.  You did not need to start a new question here, you could have continued this as part of your prior question.  I appreciate your frustration.  Waiting for test results is bothersome.  If there is visible irritation at the opening of your urethra (I do not think you mentioned this on our last exchange.  If you did, it did not register as being major), then a test for HSV using either PCR or culture is appropriate (a herpes blood test will be of little help).  If this is HSV, the valacyclovir is good therapy and should begin to help in a few days.  

This is not a wart.  Warts are not associated with pain, at the site they are present or elsewhere unless they have obviously been traumatized.

The other possibilities are the things I mentioned earlier- prostatitis, kidney stones, UTI.  Your urologist should have discussed these with you.

I hope this comment is helpful.  Please follow-up if there are further questions.  A limited number of follow-ups are permitted.  EWH