Pain and irritation at meatus during urination and ejaculation/frequent urination

[tellnolies]

Hi, about four months ago I started having some burning at the tip of my penis during urination and ejaculation, but not everytime.  Also, my meatus would become extremely irritated from contact with my underwear and I urinate frequently, expecially during the night. There is no discharge from the penis.  My sex drive is also very low, and my testosterone was below normal and I apply 2.5 mg. pack of androgel every day.  I had sex previously, but only oral.  I panicked and took 2 grams of Zithromax all at once.  This did not clear up the problem.  I then went to a urologist and he did a urine specimen, prostatic fluid extraction by massage (which did not work, so another urine specimen), and put me on doxycline for 10 days. This still didn't clear up the problem.  Now he has me on septra DS for 4 weeks and I'm into the second week and things don't seem to be improving that much.  He said my urine specimen was perfect, no bacteria, no high white cell count.   I had genital herpes about 10 years ago as well, but never had an attack other than the initial one.  I can't see any abnormalities other than the slight redness that sometimes occurs near the meatus.  

[Edward W Hook, MD]

Thanks for the clarification however this does not change my assessment.  Take care.  EWH

[tellnolies]

Hi Dr. Hook,

Thanks very much for your help.  Just wanted to clarify a little more, because I think I might have described it incorrectly.  The irritation occurs on the outside of the meatus, but the burning, when it does happen is within the urethra about 1/4 of an inch on the bottom side inside the urethra.  I'm not sure this will make much of a difference in the diagnosis, but just thought I'd mention it.  Thanks so much!

[Edward W Hook, MD]

Welcome to our Forum.  What you describe, if I follow things clearly, is increased sensitivity of the end of your penis which is not associated with any visible abnormality.  the problem has been there intermittently and is not there all of the time.  If I have this right, I have to say that this is really not compatible with any STD or, for that matter and specific infection. the symptoms of infections tend to be present continuously and typically progress.  Problems related to infections also typically have some sort of visible problem which can be noticed as well.  this is certainly not suggestive of herpes.

I must say, that I doubt that antibiotic therapy of any sort will improve this problem.  My thought would be to discuss this with a dermatologist.  In doing so however, I would not worry that it might be an STD.

Hope this provides some direction.  Take care.   EWH