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
12 likes, 867 replies
biff82624 Guest
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allan64188 biff82624
Posted
pete80031 biff82624
Edited
Thanks for contribution Biff, I think given Stevens clear HSV results and absence of any lesions we can take herpes off the table (unless you could possibly elaborate on your experience) my own symptoms have flared somewhat after a brief while of remission. As for cystoscopy I haven't had one but the GUM doc did jam a hoop shape thingy down my urethra to check for abnormal cells under a microscope (clear). I'm kind of alternating between some sort of trauma/nerve damage or a physical manifestation of a psychological problem!! We all seem to be the same age, why have we suddenly got this condition now? Millions (daresay billions-ish) of late 20s early30s men have sex with women, even if there was an obscure disease out there medical science would know about it!
allan64188 pete80031
Posted
I read a post from a guy from about 10 years ago and unfortunately no one ever responded. He mentioned two things identical to what happened to me: 1. The condom he was using dried up and got pushed down against his meatus pulling it open during sex 2. Had sex with a very full bladder (I’ve always had a shy bladder and tried to pee beforehand and just couldn’t get myself to go at this girls apartment at the time)
She also cut me with her tooth on the corona during oral sex, so who knows what kind of bacteria, virus, or oral flora could have got in there. All I know is that over the past 9 months, I’ve had every symptom that Steven described in his original post ( some have got better over time, but I’d still describe my life as a 2/10 in comparison to before all of this).
pete80031 allan64188
Edited
Allan, I'm with you on the misery scale, the only thing keeping me sane during flare up is the optimism of living in the modern age where anything seems possible. If we are serious about beating this we need to take massive action, I'm talking UK& US meet ups, start support groups, get university research trials, group appointments with the same top specialist urologists, crowd funding, diary keeping (food/stress/sex/masturbation) this may seem extreme but whatever it takes. Obviously avoiding acidic stuff, pelvic exercise and hoping it goes away just isn't enough!
danielle55208 Guest
Posted
Guest danielle55208
Posted
danielle55208 Guest
Posted
PCR is when the dermoalgist takes a swap of the suspected area and sends it to a check. It’s a deeper check. Probably worth a try the only issue my skin doctor is in 5 months from now
allan64188 danielle55208
Posted
dan19568 Guest
Posted
All,
I have the same issue as the rest of you. I don’t have the time at the moment to write out my full story but I absolutely believe this to a. Be caused by HSV-1 (Herpes) and b. Nerve damage from that viral infection. For some reason, our bodies trigger sensitivity along the pudendal nerve pathway causing neuralgia and all sorts of other weird and disconcerting symptoms. Getting doctors to understand and help has been almost fruitless. I liken this condition to be the equivalent of vulvodynia in women. I will say, this is the second time I am dealing with this. My first episode came about in 2010. Nobody was able to help... nobody knew what was going on. Back then, there were far fewer stories on the internet of guys dealing with this. I almost committed suicide because of it. I was in so much pain. Luckily I didn’t. Over the course of 3-4 years... doing nothing... it slowly went away and got better. Honest to god... I felt like myself again. Unfortunately for me... after what I believe to be a outbreak of HSV... my symptoms returned almost the same way they did the first time. I am a year and a half into this bout. I am determined to figure this out again... but it’s such an uphill battle. I do have a couple of ideas but it’s tough. Nobody seems to put any research into this category of problem. I also don’t test positive on HSV blood tests although I am certain I have it. I was in a relationship with a woman who had GHSV if I known type... she just knew she had HSV. I got HPV from her, I know that much since my wife contracted it (she was a virgin before me). So basically I am certain our issues are neurological in nature. I have gone for an MRI of my lumbar area and they did note an “incidental” finding of a Tarlov Cyst at S2. The sacral nerves are what go to your groin and genitals. These cysts, which are widely thought to be no issue, can cause extreme pain and issues in people. I have been trying to get some guys to get MRIs of their lumbar to see if they too have this Tarlov Cyst. The cysts as they call them can be asymptomatic up until a triggering event (Herpes activation) and cause symptoms. Let’s beat this thing!!! We have to. My life is so much worse with this...
Guest dan19568
Posted
This is why I am thinking about having a biopsy done-at some point. It’s the only way to test the tissue. There are no blood tests for HPV.
I’m my case, I’m also not confident that it is not trauma which caused the nerve issue... doctors don’t know obviously.
pete80031 Guest
Posted
Lads I totally understand the stress, really I do, but I can't fathom this obsession with herpes. If only it was herpes, wouldn't that actually be good in comparison to this phantom disease?! Are dudes purporting herpes US based? Because I think it's really a preoccupation phenomenon of that side of the Atlantic, my only reference points for herpes are US popular culture (south park/Neil Strauss book) Nor do I want to sound like I'm in denial, if we have some a-typical herpes then so be it but I'm fairly certain we dont!! But seriously dudes we don't have HIV or cancer isn't that something to be relieved about? On a good day my only issues are the fact that my penis doesn't look like my penis anymore, and maybe a slight urgency to urinate, on a bad day it's like my urethra has broken glass in side it. Now if we are all experiencing the same thing wouldn't we have a gradually onset of symptoms, a peak, then a remission...rather than a good week here a bad week there? Like people (to my knowledge as I've never had one) don't have a cold sore one day then gone the next then back the day after do they? Now I'm just going to sign this off by saying that in the ICD10 clinical coding books psychogenic penis pain is a recognised ailment, F45.5. Its a bit of a cop-out as clearly we have all had a trigger but why aren't we getting better? and why can't highly trained specialists seem to diagnose us? I'd be really interested to hear from the guy whose dad is a doctor, at least that's a medical specialist with a vested interest in sorting this out, thanks for reading guys hopefully I haven't caused offence anywhere
allan64188 pete80031
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pete80031 allan64188
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That's interesting Allan, though the dermatology profession would need to sort themselves out based on the info on here, anything not melanoma and there fore non life threatening doesn't seem to even warrant their attention though I bet they charge enough (thankfully free on NHS which is good as I'd be asking for a refund if I did pay for non diagnosis) my own situation started by me self treating a slight raised mark on shaft which appeared a few days after an intense intercourse session, it could have been friction, condom reaction, the tight jeans i wore all weekend in 30celsius heat, or most likely nothing at all!! But my mind had already connected the dots! The vast array of creams i applied got into my urethra and unleashed hell (I can't even remember if I'm telling this right, the mark might have appeared on glans) symptoms on and off ever since, definitely had 2 weeks of barely noticeable
allan64188 pete80031
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dan19568 allan64188
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allan64188 dan19568
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Has anyone tried taking something like acyclovir? Not even sure if that could help but if this is HSV1 related then I doubt it would hurt.
dan19568 allan64188
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Well... unfortunately... it didn’t help. In fact... I think it may have had the reverse impact. I started taking it in March of 2017 and I had two back to back episodes of terrible flares a week to a week and a half after starting Valtrex. I don’t get blisters or lesions per say... but the skin around my anus got fiery red and itchy to the point of madness. The glans of my penis was incredibly sensitive... the type of sensitivity you feel with say a really itchy and tender mosquito bite... but much worse. These flares lasted around a week and would subside. After the second one in one month... I decided if it was HSV... the Valtrex was definitely not helping me. I have read that Valtrex doesn’t work for everyone and that for some... it may seemingly somehow cause increased viral activity.
That was a very defeating experience because I was so convinced that if I simply got a prescription for Valtrex... my body would be able to get HSV under control and let my nerves calm down. I am still determined my problem is caused by HSV... but not so much convinced my residual problems are solely HSV. The fact I have a Tarlov Cyst at S2 which is where some of the sacral nerve roots emerge from the spinal cord that feed the pudendal nerve is concerning. I am hoping that through continued talks with other guys... we may be able to narrow down some type of commonality between us so we can figure out how to treat this!