4 Months of Penile Pain, Irritation, Dribbling, Rash - No STD or Diagnosis. Help!

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Hello, I am seeking advice! I am 32 years of age and situation has lasted over 4 months. It started when a female at a strip club slid her hands into my pants and rubbed / grabbed my erect penis near the urinary meatus (opening). I felt a sharp pain at the time (not sure why honestly). I feel like perhaps it was due to her rubbing near the meatus.  The symptoms below started almost immediately from what I can recall.

Symptoms:

1. Slight rash on the top of the penis glans (head of penis). It is worse after a hot shower. It comes and goes, and can appear almost like a plaque covering, scaly at times. It sometimes starts at the top of the corona (where head meets shaft) and runs straight down to the urinary meatus (opening) like a stripe.

2. No visible lesions (or blisters) or warts on the exterior skin surface. Does not appear to be any internally as well and doctors have not been able to observe anything.

3. Slight purple on one side of urethra, when the meatus is opened to look inside. A small bump is near the top of the purple, or tip of the meatus; however, two urologists believe it is vein related.

4. After urinating, urine dribbles out of the bottom of the meatus. The meatus opens and closes (at the bottom) and urine drops drip / discharge. I have to wipe considerably. The glans around the meatus looks swollen (more one side) and when I press on it, urine will discharge. It is almost like urine gets stuck in the tip of the urethra.

5. No noticeable discharge, but the penis appears and feels “wet” inside, especially post urination. It seems that I am leaking / dribbling throughout the day, after urinating. Urine color is clear.

6. Pain consistently on the underside of the glans near the meatus. The pain can sometimes be very sharp and burn. I also feel a tickle or tingle sensation in the head of the penis that comes and goes. The entire glans is sensitive to touch. This is extremely irritating.

7. The meatus looks red and inflamed at times. It can be very sensitive or painful to the touch and irritated by clothing. This feeling comes and goes in intensity.

8. The bottom of the meatus opens wide (top remains closed) when the penis has increased blood flow and/or is erect. This is abnormal for my body. You can see directly into the urethra when this happens.

9. When erect, the glans / head region seems larger than it had previously and I would describe it as swollen. There is also an internal pain near the underside of the meatus, where it opens up near the bottom (as described). Feels like it is stretching / pins and needles.

10. The glans has a more prominent reddish rash, during and after an erection. The rash appears like I have scaly / dry skin. Post ejaculation my urethra appears red and inflamed as well, when looking inside the meatus. This subsides after some period of time.

11. Semen color seems to be more yellow that I remembered, prior to this incident. Sometimes I feel like there is pressure on the front of my testicles.

12. The pain and irritation increase throughout the day. When I wake up in the morning the symptoms are not as noticeable, besides a dull pain on the under-side of penis glans. Sometimes there is some redness on the top of the glans area.

Testing:

I have been well tested (multiple times) and am negative for the following STD's; HIV (RNA testing done as well), Chlamydia, Gonorrhea, Trich, HSV-2, Syphilis, Mycoplama & Ureaplasma, Hep A, Hep B, & Hep C. Again, all negative.

I found in this process that I am HSV-1 positive and likely have been for some period (so is a large % of the population).  I have had  blisters and a HSV like rash on the bottom of my nose in the past. I don’t think this is HSV-1 as there are no lesions in my genitals and this has gone on too long.

Due to viral load factors, I tested the viral infections (HIV, HSV-2, Hep) at 30 days and again at 95 days post exposure. I assume that I am in the clear based on statistics, but am certainly not a doctor. These tests were unlikely to be positive given the event as there was no intercourse.

Urine analysis looked okay. Red and white blood cell counts were okay, no bacteria infection or UTI found or diagnosed based on urine culture.

Treatment:

I have seen 5 urologists, 1 dermatologists and 1 family practice doctor. I have had 2 cystoscopies, and nothing was found (same urologist).

A family practice doctor thought it was due to some soap or lotion, but referred me to the 1st urologist. He thought nothing was visually wrong.

The 1st and 2nd urologist  said they have no clue as there was nothing outside of normal visual tolerance. The 2nd urologist gave me the 2 cystoscopies (camera up the urethra to the bladder) and nothing abnormal was found.

2nd urologist thought it was contact dermatitis due to the rash as nothing surfaced in either cystoscopy. My prostate was examined physically and was ruled to be okay. He referred me to another urologist and also said I should see a dermatologist.

The 3rd urologist confirmed the inflammation in the glans. He suggested to try Quercetin (there are clinical trials which have shown it has helped the prostate) and then potentially Doxy over a longer period as a next step (can be anti-inflammatory). My fear is taking an antibiotic without having a bacteria pathogen diagnosis could be pointless.

The 4th urologist (who the 2nd urologist referred me to) believed that this was related to nerves in the penis. He is a pain specialist and put me on Nortriptyline.

The dermatologist (urologist said I should see one) also saw inflammation and diagnosed the rash as a non-infectious seborrheic dermatitis. He prescribed a topical antibiotic / corticosteroid, which I used. I also tried a steroid. It has reduced some of the redness but not relieve any of the described pain or urine dribble. I am concerned about the use of a topical for an extended period (skin thinning) and have stopped using it. I have a follow-up visit with him scheduled.

Medication:

1. Doxycycline 100mg x2 times a day for 10 days, initially when symptoms started. No relief.

2. Topical cream for rash: Ala-Quin initially for 4 weeks, then tried another steroid cream. Has somewhat resolved the rash issue (not totally).

3. Metronidazole (Flagyl) 2g, x 1 dose for Trich as there is not a great test for this (urine apparently has weak sensitivity). Trich can cause swelling, come and go symptoms, etc.

4. Nortriptyline 20mg every day to resolve nerve issue. I just started this.

5. Supplements currently taking: 1g of Quercetin daily (shown to reduce inflation in clinical trials), Multivitamin, AHCC, Folic Acid, Vitamin E and B12.

The symptoms continue to persist and these treatments have not worked.

My Questions:

1. Does this sound like an STD? Could it be another bacteria pathogen or NGU?

2. If this nerve related due to some trauma, would it cause the rash?

3. Are there any ideas regarding further testing or a diagnosis? I was considering a semen culture but don't know where to have this done.

4. Would a HPV virus cause these symptoms? In men, I believe the HPV virus is typically asymptomatic and/or presents itself with warts.

5. How can I test for HPV other than a biopsy of the penis or penis scrape (which most doctors don’t perform)?

6. Could this be yeast related based on the symptoms? I have noticed an increased coating on my tongue which scrapes off and dry mouth symptoms. I have also noticed the coating and dry mouth is much worse after drinking alcohol or eating sugar (yeast related).

I should mention that my anxiety over this is through the roof and am aware of some changes in my body as a result of it (anxious, no hunger at times, weight loss, etc.). I also think the dry mouth could be related to anxiety.

Please, I am looking for some help! I know there is someone out there that can help me as this has gone on for so long. This is such a struggle and always on my mind.

Further, I am terrified about infecting a new person who I just started dating. A couple doctors indicated that I was safe to have intercourse as I was well tested, but I don’t feel right about having intercourse with the symptoms persistent.

Thanks all for your help. - Steve

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  • Posted

    Have had this for a little more than 5 months now. Can relate to all 12 of your points (though the part of the meatus that is open for me is the top half). Tested negative for everything under the sun, did two weeks of doxy and month of cipro. Mine came about a few days after oral sex (w/ skin breakage on the glans due to a tooth nick) and condom break in the same week which obviously fuels my anxiety in terms of the possibility of infection. 

    By far the worst part is rubbing on or touching any clothing. Seems like recently yours has been getting better. Any meds you think have helped or tips that you'd suggest? I've recently moved onto quercetin and anti-inflammatories. Haven't tried too many creams yet. Also, you mentioned in your original post that your anxiety was high. Wondering if calming that down helped at all, or if your anxiety just went away as symptoms started to. Feel like doctors are running out of ideas and I really just wish I knew what this was all from. 

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    • Posted

      Honestly time seems to be the only thing helping. I was using different steroid creams and I firmly believe they were causing more/different issues. I have been putting vasoline on my glans to protect it against my boxers and urine dribble and it seems to help. Some of the redness has also resolved.

      I have met with some  experienced doctors and they keep telling me that I am fine. It’s frustrating when I hear this, as they have all acknowledged my inflammation and symptoms. 

      I am leaning towards nerve damage at this point. This is what one of the urologists suggested was wrong.  I took psych meds to help with the nerve issue and it did seem to take the pain away.  

      I have been very thoroughly std tested, had 2 cystoscopy exams, had an ultrasound, and now even a semen culture and nothing had surfaced.

      Keep me posted and I hope you heal.

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  • Posted

    what kind of cream did he prescribe you that helped with the redness?

     

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    • Posted

      I used three different steroid creams. Ala-Quin, Valisone and another steroid cream. I saw different  dermatologist. I felt like the steroids were  creating more inflammation. They also cause skin thinning  (long term use), so I stopped using them. I have been putting vasoline on and the redness on my glans is going away.
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  • Posted

    Hey Steven. When do you feel the sensations in your penis? Do you feel anything after you pee? First thing in the AM? Does it wake you up during the night?
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    • Posted

      It's normally not as bad when I wakeup, but tends to get worse when I sit down for a while at work.  I'm currently on a z pack from a 3rd urologist. He said if it isn't better in a week to go to public health and get tested again just in case.   

      I'm beginning to wonder if it is prostatitis and the urine leakage is causing the tip pain/irritation.  Working out seems to calm the pain during the workout but it returns.

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    • Posted

      Does urine actually leak? Reason I ask, I have similar symptoms to you and am also beginning to believe it is prostatitis. Urine doesn’t leak for me though, just the feeling that there is some semen/fluid flowing towards the tip of the urethra. Hope we can get this figured out man!
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    • Posted

      For me it comes and goes. It does get worse throughout the day however and seems to be the worst around urination...for a while the pain was overwhelming (throbbing pain) but this has subsided now. I still have redness/discoloration on my glans as well, which also comes and goes. 
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    • Posted

      Hi Steven,

      How is your situation going?  I'm going to 2 different urologists on Wednesday.  This is going on 5 months for me and from what I've read, you and me have very similar issues. I keep taking pictures when my meatus is inflamed and area around the opening. It looks like my meatus is swollen, but it also feels that way on the inside along with pain.  

      Does yours look like this at all? 

       

      Moderator comment:I have deleted the links to the images as they went to a site unsuitable for inclusion in the forums. Users can upload images directly to this site by using the icon at the top right of reply boxes.

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    • Posted

      I can’t tell anything looks off based on your picture. I just have redness, which comes from time to time - and I think it’s internal as well. Let me know what your urologist says. I am really curious.
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    • Posted

      Just got back from urologist 1 of 2 I'm seeing today. 

      Talked with her for a while and she said it looks irritated on the inside, so I'm going to try betamethasone for a couple of weeks as well as taking ibuprofen everyday.  She said to put it inside my urethra and it is safe. 

      She said if the betamethasone/daily ibuprofen doesn't help then go see my primary care physician to make sure there isn't some other kind of inflammatory issue going on with me.  She said she could put me on 6 weeks of continuous antibiotics but she doesn't want to because it would probably make me sick and could cause other issues since I've already been on lots of antibiotics.  

      I will report back what urologist #2 says that I'm seeing this afternoon.

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    • Posted

      Just went to the 2nd urologist of the day.

      He said nothing looked irritated.  (guess to him it didn't).  

      He was at a loss and thinks it may be a dermatology issue so told me to go to dermatologist.  

      I'm not gonna lie, I don't want to live everyday of my life in pain like this. I'm almost at a loss at this point.

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    • Posted

      Saw your picture - although I'm just a regular guy and not a doctor, to me your meatus looks irritated or inflamed. I've definitely still got my fair share of issues, especially urine dribbling, but the anti-inflammatories that I've been taking (Meloxicam and some supplements like Quercetin) are definitely helping with the pain. Also regular hot baths. I'd try the cream and the ibuprofen. Try like 800 mg (400 mg probably isn't going to do anything). 

       

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    • Posted

      ... I have also read that bee pollen helps too. i saw a urologist - not a typical doctor type as he is the one who told me about studies on quercetin. he also recommended bee pollen - which apparently helps with inflammation in the body.
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    • Posted

      John.... I did not see inflammation from the picture you posted. I am just being honest. Does not mean it is not there... as I heard the same thing from urologists.

      I had severe pain initially and one of the urologists assessed that I was dealing with neuropathic penile pain. It is possible that this can cause the inflammation. The doctor put me on a low dose neuro drug that did help resolve the pain - but I will tell you it also led to depression for me. But, once I came off the drug most of the major pain was gone. I still have symptoms, but I can make through the day now without throbbing pain. 

      Was there a specific event that caused your issue?

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    • Posted

      It all started on January 15th, 3 days after intercourse with a girl who says she is a stripper. I started getting a stinging tingling type feeling on the exterior of the opening. 

      I did have a bit of stress going on besides worrying about that, so not sure if that led to all of this.  I would be afraid of trying anything that could cause depression because I am already somewhat depressed from this issue. 

      I take pictures whenever there is visible inflammation to my eyes and I show the doctors.   Attached are some other pictures when it is really bad.  I'm not sure if I should go to the dermatologist and have them do a "scrape" or not.  The urologist said not to do a biopsy because she's had people come back in after a biopsy and can't get an erection or have a curved penis afterwards. She said a "scrape" would be fine though, but where this is on the glans I'm not sure how they would do that.

       

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    • Posted

      Have you noticed increased wrinkling on the glans or would you say it looks roughly the same other then the inflammation? Previously mine was very smooth but now has more of a wrinkled and red look (rather than smooth and pink). Also, mine similarly started after a sexual encounter with a girl that I later learned had been sleeping around a fair bit before we met. 
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    • Posted

      It looks the same other than the inflammation. 

      I just talked to the dermatogist and she do NOT use betamethasone on the genital area.  It’s amazing that the urologist told me it was fine to use that inside my urethra. 

      I will be using desonide and then getting a scrape soon.  Going to primary care doctor tomorrow to make sure something else isn’t going on.

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    • Posted

      Whoa - my dermatologist indicated the same. He said that long-term use of corticosteroids such as Betamethasone can cause skin thinning in penile tissue. I told my urologist about this conversation and he told me to stop using it. 

      Keep us posted on the scrape. Process, pain, and recovery. 

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    • Posted

      Good to know. Had read similar online but my urologist has suggested using steroid creams so I was honestly just trusting him (wasn’t going to use much though). 

      Where exactly will you get this scrape?

      Also just wanted to note that with everything I’ve been taking/doing, I haven’t moved backwards in like two weeks and may have even had some continued improvement. Although I’m still having pain, previously I’d have some improvement for a few days and then spiral back down immediately after. 

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    • Posted

      Update:

      I went to my primary care Dr and he couldn’t see anything wrong. Still waiting on some bloodwork he sent off or different things.  He referred me to another dermatologist who I just got back from.

      She couldn’t see anything.  I showed all my pictures to her.  She wouldn’t do a biopsy because of where it is. She gave me a potent steroid normally used for lichen schleroris which I will use for 2-3 weeks.  If that doesn’t help then she will talk to a Urologist at the hospital to do a biopsy.  I asked about a scrape and she said it would need to be deeper.  

      Almost thinking of going to the other dermatologist to just scrape it. I’m so tired of trying creams that don’t work.

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    • Posted

      when you met with the first dermatologist, what did he think could possibly show up in the "scrape" or biopsy? in other words, what would a dermatologist be potentially testing for? he would have to instruct the lab to test for various conditions. did they have any indication what could be causing the issue? 

       

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    • Posted

      They would be able to see under a microscope the size of the cells and said they had many different ways to tell what it is.   The problem with mine is that it’s very close to the opening so they’re afraid to mess something up.
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    • Posted

      Aleve seems to be helping my pain/inflammation. I’m still using the super potent steroid, Clobetasone.

      I am still confused about what’s going on. I have redness that flucutuates on the exterior around the opening, and the ridge of the opening swells.  But I also have pain inside my urethra.  If I don’t urinate for a few hours and then go, it seems to be stuck at the opening and then sprays.   They didn’t see anything in my cystoscopy but it defintelt swells on the inside.   I hope the steroid/aleve can reduce the inflammation to help whatever it is heal.

      Really becoming depressed about this.

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    • Posted

      Same with just about everything. Urine definitely makes everything worse. Anti-inflammatories seem to help but don’t seem to solve anything long term (though the longer I’ve been taking the anti-inflammatories I seem to have less urethral pain and less dribbling). Also I have urinary hesitancy that feels like it’s caught at the tip as well. Additionally, feels like I have dribbling because there’s urine that doesn’t make it past this spot. Cystoscopy showed nothing though. 
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    • Posted

      I asked the nurse practioner about a urethrogram today and she said she didn’t think it would give us any new information.   Kind of irritated me. 

      How long have you been taking the anti inflammatories and at what dose for the pain to go away?

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    • Posted

      My urologist gave me Meloxicam which is a prescription anti inflammatory often used for arthritis. It has a half life of over 20 hours so you don’t have to take every few hours like ibuprofen. I’ve also been taking quercetin twice a day.

      This has not entirely erased my pain, but it’s probably 70 or 80% better than my worst. And I seem to be still improving.  

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    • Posted

      I may ask for those if the Aleve doesn’t work. 

      I just started trying Urimar T.  It’s like Azo but has some extra things in it. It turns your urine radioactive blue.  So if I can reduce inflammation with that, thr Aleve, and the steroid cream, hopefully I can knock it out somehow.

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    • Posted

      Update:  my GP got the bloodwork back and it showed elevated inflammation in my body.    He wants me to come in for further bloodwork so I’m going to the lab tomorrow.  
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    • Posted

      Was it an elevated white blood cell count? This would be consistent with an infection in the body... If not white blood cells, how did the Dr. determine that you had elevated inflammation? 
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    • Posted

      No my white blood cell count looks normal, unfortunately, or the antibiotics would’ve knocked this out.

      This was a CRP - C reactive protein test.  Apparently it is a marker in the blood that rises in response to inflammation.  It doesn’t specify where in the body the inflammation is though, and could mean a variety of things.

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    • Posted

      My Uric Acid level was a 6.8 which is on the high end of the range called hyperuricemia.  Waiting to hear back on my other results and see what the Dr thinks is going on.  Hoping something makes sense from all the results.

      Also, may be trying an oral steroid for to see if it breaks the inflammation cycle. It feels like my prostate is the issue to me.

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    • Posted

      I feel this exact thing!!!

      It is almost like urine gets stuck in the tip of the urethra.

      . I also feel a tickle or tingle sensation in the head of the penis that comes and goes. The entire glans is sensitive to touch.

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    • Posted

      hi , i had put a post up on here before but i can't find it now, i think your picture looks alot like mine does/did, I've had this for a year and a half and tried all the creams under the sun and nothing worked.....until i went to see a dermatologist (my 2nd one privately)

      and he said to use a combination of allergy tablets and a very small dose of anti depressants, along with a cream... i suppose to cover all areas right? he suggested this as he believes i had damage to some nerves from tampering and constantly rubbing the meatus!

      this was to use for 2 months one allergy tablet in the morn and one anti depressant at night, I'm just over a month in and still had no luck, UNTIL i rung my gp explained what course I'm on and he prescribed me extra of the anti depressants and told me to up that dose to 2 tablets at night..... literally done this for 2 days so far and i swear i can see the redness and the puffyness has gone!!!! and of course the horrible niggly sensation has gone aswell!!!! i am going to keep taking this course for the 2 months as originally scheduled but with the extra dose of the night pill! i really hope this has helped anyone reading this i know how bad this is for you all, it has put me in a very bad place but i think I've finally cracked it!! i say think tho and hope it stays good!!! best it's been for a year and half tho so gotta be worth a shot,

      what I'm taking are

      zirtek allergy 10mg x1 in morning

      dosulepin 25mg x2 at night

      balneum plus cream twice a day

      i would follow what i done and take only one dosulepin for a month then up it to 2,

      ask your doctors people!!

      i probably won't see any replies as i forget passwords ect

      but all the best !

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    • Posted

      just to add, my symptoms were

      dry looking and feeling tip.

      sometimes red sometimes just shiny dry looking.

      sometimes puffy and that did hurt.

      very tender after urinating against underwear.

      ok in morn then get gradually worse as the day went on.

      sometimes better at night, but the working day was when it most noticeable

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