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Stinging, Burning Penis

A number of months ago I had unprotected vaginal sex with a friend of mine whom I trust. She has claimed she is STD-free. I did however notice a very strong fishy odor from her vagina, and discharge on my penis after intercourse.

About two days after the encounter, my penis started to sting and burn on the inside, and I had a lot of urinary urgency. Urinating doesn't make the pain worse, and there is no discharge I have noticed. The penis head also became very sensitive--just rubbing it a bit caused it to become very red and painful to the touch.

Urine culture was negative, but PCP gave me Cipro (500g twice a day, 10 days), which didn't alleviate symptoms. All STD tests were negative, except for Herpes II, which I've been reactive for in the past but have never noticed an outbreak.

The stinging and burning has not gone away, and from time to time I have a dull ache in my testicles. Often the stinging and burning feels like it is deep "inside me" if that makes sense, with the pain feeling like it goes down into my anus. Ejaculation is *incredibly* uncomfortable, and leaves me feeling like something has gotten caught along the way, and I have horrible burning pain for hours afterwards, down throughout my penis, testicles and anus.

I have seen PCP again, who repeated urine culture test (after prostate massage) and found it to be negative for both bacteria and white blood cells. PCP even cultured urine for Mycoplasmas, and it was negative. PCP assumes this is an abnormal Herpes outbreak, and has given me Valacyclovir, which hasn't helped at all, and I've been taking it for about a month now.

Anyone have thoughts on what this might be? Is there anything that might be overlooked here, and that I should ask my physician about, or is there anything I should seek from another physician?
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239123 tn?1267651214
Welcome to the forum. Thanks for your question.

I agree with your PCP's implied conclusion that you have no bacterial STD (gonorrhea, chlamydia, NGU, etc).  However, I strongly disagree with his "assumption" that you have herpes.  Genital herpes symptoms never are anything like you describe, and herpes could not continue to cause more or less unchanging symptoms for several weeks or months.  The absence of both bacterial infections and herpes are reason that neither the antibiotic (ciprofloxacin) nor valayclovir have had any effect on your symptoms.

And by the way, you cannot catch a new episode of genital HSV-2 if you're already infected, as shown by your positive blood test.  That alone rules out herpes as a possibility for these symptoms.

So going to your question, "...have thoughts on what this might be?".  I'm confident you have absolutely no infection from the sexual exposure you had a few months ago.  However, it could be related to that event through psychology.  Many of your symptoms are quite typical for genitally focused anxiety, which often follows a sexual exposure that in retrospect is regarded with shame, guilt, or regret; and it can start a vicious cycle, in which the symptoms themselves foster still more anxiety.  This doesn't mean it's all in your head, as some people assume.  It's just that anxiety clearly lead to magnification of minor aches, pains, and normal body sensations.

A variation on this is the chronic pelvic pain syndrome or chronic (non-infectious) prostatitis.  Google CPPS for more information (spell it out) and start your reading with the excellent Wikipedia article and the information you can find from the Stanford University Dept of Urology.   You may notice a lot of overlap with your symptoms.

So I suggest you stop the valacyclovir, and discuss these other options with your physician.  If he or she agrees it could be CPPS or prostatitis, then perhaps you should see a urologist.  In the meantime, don't be overly worried.  CPPS/prostatitis is rarely harmful in the long run, either for affected men or their sex partners.

Finally, I hope you informed your partner of your HSV-2 infection.  Regardless of ever having an apparent outbreak, people with postive blood tests are infected and can transmit the infection to their sex partners.  You should be telling every potential partner about it, before having sex the first time.  If you haven't discussed it with the friend from a few months ago, you should tell her now.

Perhaps some of this information isn't what you were hoping to hear, but I hope it has been helpful.

Best wishes--  HHH, MD
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