Penis bump

[deerdan]

Hi Doctor,  

5 1/2 weeks ago I had a brief unprotected encounter with a woman. There was brief (maybe 5 min tops?) unprotected genital contact, and briefer penetration (maybe a min?). About 2 1/2 weeks later I noticed what kind of looked like an abrasion about 1/4 of the way down the shaft of my penis, I immediately went to urgent care and was told "not to worry". I had masturbated with no lubrication the night before, but the doctor was rather brief, so I went to planned parenthood 3 days later and had another person look at it, he said if "you're worried about herpes or warts, that is not it". Now, 3 weeks after the last dr's visit, the bump is still there. I've looked at it fairly closely, and it looks almost like a skin tag, a flap of skin or something that is flat and slightly sticks up. It isn't painful or itchy, but it is still concerning given the unprotected encounter... It also looks like it is at the end of a small scar I have on my penis (maybe from circumcision?). In the past 5 1/2 weeks I've had burning during urination once and cloudy urination once or twice. I've also noticed a sticky clear goop on the tip of my penis a couple times, once after waking up w/ an erection and once after a bowl movement. I can also produce this sticky clear fluid when I 'milk' my penis sometimes, but not all the time (or even the majority of the time) I try. I've been tested for bacterial infections (gave urine) and those came back negative. I plan on getting tested for HIV, syphilis, and HSV next week sometime, after the 6 wk mark. I'm just wondering if any of the things I've listed above sound like an std, particularly HSV or warts. I'm very concerned even though two doctors told me it was nothing... It has not gone away. Also, I was wondering if the test results came back negative at 6 wks, whether or not I could be confident I did not have HSV or HIV. Thank you.

[Edward W Hook, MD]

Thanks for the follow-up.  Again however, my advice to to not have the HSV test.  Take care. EWH

[deerdan]

Hi Doc, just thought I'd let you know I went to the dermatologist and (again) was told that it was nothing to worry about and that it will probably just go away. With 3 docs now telling me 'not to worry' at different stages, I think I'll just ignore this thing now. I still plan to have HIV and syphilis tests done next week, but I'm still unsure about the HSV. I guess w/o lesions in the first 2 weeks there is no reason for me to think that I have it? Thanks again for your help.

[Edward W Hook, MD]

Thanks for the follow-up.  It was not clear to me that it had changed.  Seeing a dermatologist is the right thing to do.  when you do, I suggest that (if htis is the case) that it is important to you to know what this is, not just to have it treated "just in case".  The treatment of such lesions tends to be non-specific and can make many types of skin lesion ressolve.  I suspect you want more information.

Flase postive HSV tests are influenced by many variables.,  In some populations as many as half of the tests are falsely positive.  Unfortuantely, many of the people who order the tests, as well as those who are tested do not know this or how false positve results can be ressolved.  You need to get over it and move forward.  Test at your own risk.  EWH

[deerdan]

Hi Doctor, thank you for your input. My concern is that it looks substantially different now than it did when the 2 docs evaluated it.  I've made an appointment with my dermatologist for tomorrow to have them look at it. My main concern is whether or not it is a wart... It is very small, but it is kind of a flat fleshy thing, kind of like a piece of empty skin. If the dermatologist says nothing to worry about, I won't think about it again. Re: gonorrhea and chlamydia, I was tested and both came back negative.  Although, this morning I had some extremely painful burning w/ urination and there were white flakes of something left in my urethra after going to the bathroom. I think this may be due to dehydration, or something? In any case, I've had this happen before (the white flakes or crystals and burning during urination). One final question... what is the likelihood of a false positive for HSV? I just know that I won't be able to forget about this following this incident, and I'll be looking around for something on my genitals forever. I also think that a false positive would cause me a great deal of stress, but I just don't think I'll be able to let this go and I've never been tested for HSV. Thank you again for your input and advice.

[Edward W Hook, MD]

Welcome to the forum.   I will try to help.  My sense is that you have become, for some reason, quite anxious about having gotten an STD from this exposure.  You do not mention whether or not you have been tested for gonorrhea and chlamydia but I am going to presume you have been.  If you have not, I would suggest that the most important testing you need is for these organisms since they are the most common possible (but still unlikely – most people do not have STDs and most exposures to infected partners do not lead to infection) consequences of the exposure you mention.

The bump you mention has been examined by two trained health care providers who felt it was not a manifestation of an STD and who felt no need to test.  My advice is to believe them.  You have a good alternative explanation for the abrasion you noted and 2 and 1/2 weeks is a bit long for HSV to become apparent- typically it is apparent within two weeks of exposure.  I would not recommend HSV blood tests in your situation since there is a statistically higher likelihood of a false positive result than actually finding out that you have HSV.  

As for the discharge you note, most men typically have a small amount of genital secretions present in the penis. This is more evident following overnight erection, can occasionally be expressed when having a bowel movement and can increase from the irritation of repeated self -examination.  Again, presuming that you have already been tested for gonorrhea and chlamydial infection with negative results, you need to not worry further.

for the future, my advice is to use condoms for such exposures.  Take care.  EWH