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Avatar universal

Symptoms

Hi. Male, 41, monogamous for 12 years, except for this highly regretable incident. I have some questions regarding symtoms and risk. 10 1/2 weeks ago received short protected oral at strip club. No other exposure or touching. 2-3 days after exposure tenderness at meatus. Took Azitromax 1000 mg and later Cipro 1000 mg ( not tested).  Also tried Valtrex 7 days with no change in symptoms  Daily symptoms up til today, tender and slightly swollen meatus, utethral discomfort/ slight pain. No apparent blisters or ulcers, no discharge, normal lymphnodes. Last 4-6 weeks pinprick pain in legs, feet, nates and hands.Tested at 2 weeks: hiv, chlam, syf, mycopl, urine, hematology- all normal. At 4 weeks Gon and Hsv combo- negative. 6 weeks utethral smear- normal. 8 weeks: Hsv combo and hsv2, syf, hiv, urine, hematology- all normal.  Urologist at 9 weeks, he stated normal visual inspection. Prostate: tender and swollen right lobe, possible prostatitis. treated with Cipro 500 mg x2. Symptoms more or less the same at day eight. I do know that my exposure was low risk, and that I am obsessing about this, but the continuing symptoms really do scare me. Could this still be hsv or should i trust the results? Could genital focused anxiety precipitate prostatitis or prostatitis like symptoms?  Could prostatitis cause tender meatus and urethral Pain? plan to retest Hsv at 12 Weeks. Very afraid of transmitting something to my partner, is there still a risk? Sorry for the long post. I just need to get an expert opinion and try to get this off my mind and move on. Thanks
5 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum.  I'll try to help.

Briefly, you had accurate advice on the herpes community forum.  Herpes does not cause the sorts of symptoms you describe.  Tingling and other kinds of discomfort can accompany or precede overt herpes outbreaks, but herpes outbreaks or other symptoms do not occur alone and never last weeks on end.  "Pinprick" sensation in hands and feet is a classical anxiety symptom, often as a consequence of hyperventilation.  Your STD test resuls are highly reliable.  Further your exposure was oral, which is low risk for STDs even when unprotected -- and you apparently had condom-protected oral.  On that basis alone, it is simply impossible that any STD from that event explains any of your symptoms.

Based on your urologist's assessment, it seems you may indeed have prostatitis, or perhaps the chronic pelvic pain syndrome (which is often a physical manifestation of anxiety, stress, guilt, etc.  You can google CPPS (spelled out) for lots of information; start your reading with the excellent Wikipedia article and information from the Stanford University Dept of Urology, both of which will be near the top of the google hit list.  Discuss it with your urologist.  And yes, problems originating in the prostate routinely cause discomfort at the tip of the penis -- it's called referred pain.

Prostatitis and CPPS are not sexually transmitted diseases.  If they have any connection with your protected oral sex exposure, it is only through an emotional/psychological mechanism.

I recommend you not be tested again for HSV.  You could not possibly have caught it.  If It were to become positive, it would not explain your symptoms.  It would only mean you have a prostate problem or CPPS, plus asymptomatic herpes.

As for "the continuing symptoms really do scare me":  There is no cause to be scared.  You have nothing serious.  Prostatitis and CPPS are inconveniences, not important health threats; the only problem is the discomfort, not internal damage.  Neither you nor your sex partners is ever going to be seriously harmed by this problem.  You can confirm this with your urologist.  To the extent that some or all the problem is psychogenic, coming to believe these facts may be the most important step in getting beyond it.  People can and do live with all sorts of discomforts once they are confident there is no underlying serious health issue.  Just think of all the people who go through life without being all that troubled by their chronic back pain or recurrent headaches.

I hope this helps.  Best wishes--  HHH, MD
Avatar universal
Doc Thank you for your answer. I find it comforting although, as I said, the continuing symptoms keep me thinking about possible Hsv. 2 days after unprotected intercourse with wife 9 days ago I developed a circular rash on the right side of glans, not tender or painfull, skin scaling after 2 days, no ulceration, improved with dactacort cream. It again fueled my anxiety, and today wife asked for klotrimazol kream so she proobably suspects a fungal infection. Diden't dare to ask her about symptoms. Most likely explanation is candida, but  The thougt of possibly having infectes her with Hsv terrifies me! With timecourse, negative Hsv combo at 4 and 8 weeks and type of exposure it should be impossible! The situation fueles irrational thoght; all the "what
Avatar universal
Sorry; "what if's". I really need to find a way to settle this soon. Additional advise/ thoughts would be highly appreciated. Thanks again!
Avatar universal
One last comment: could my prostatitis be contagious to her? Still taking Cipro 500mgx2.
239123 tn?1267647614
MEDICAL PROFESSIONAL
As I said above, "Prostatitis and CPPS are inconveniences, not important health threats; the only problem is the discomfort, not internal damage.  Neither you nor your sex partners is ever going to be seriously harmed by this problem."  Prostatitis is not sexually transmitted or acquired.  You have nothing your partner can catch.  (You may not have any infection at all. Many [most?] cases of prostatitis are due to inflammation not caused by infection.  If cipro helps, fine; but don't get your hopes too high about it.)

That will have to end this thread.  Take care.
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