Bump inside urethra/meatus swollen meatus after oral sex

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Hello,

I have received unprotected oral sex from a prostitute. A couple of days later I noticed that my meatus was swollen and that I have a red bump on the inside of my meatus right at the opening. I have a little bit of discharge coming out too what looks like pre cum. I also need to urinate more frequently and it itches/irritates a little. I have tested negative for the following STD's:

Chlamydia, gonnorrea, Trichomonas and Mycoplasma.

My doctor thinks it could be a NSU/NGU and gave me 1000 mg azitromycine. That did not work and then he gave me doxycycline for 7 days, 2 tables a day.

I noticed no difference at all after both antibiotics.

I will attach a couple of pictures to give a more detaild view.

Does anyone has the same or knows what this could be?

Thank you in advance

https://imgur.com/m4DEhMk

https://imgur.com/Ni8tFev

https://imgur.com/jP46I5X

https://imgur.com/uVOjvBt

https://imgur.com/J7b6k9g

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6 Replies

  • Posted

    Dear robert,

    Your photos are all out of focus, so cannot comment on what it looks like. Reading what you're experiencing and the lack of any response to the standard antibiotics for urethritis I suspect you may have a viral infection; and the only STD that hasn't been checked or treated is herpes (HSV).

    Did your doctor raise the possibility that it could be herpes urethritis? It's not uncommon, but the test requires a swab (not urine test) of the meatal area (the opening of the pee hole) that's swollen/inflamed. If you still have symptoms, I suggest you go back and ask them to test you for this and in the meantime to prescribe oral aciclovir as a therapeutic trial.

    Rgds,

    Adhari

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    • Posted

      Thank you for your response Adhari.

      My doctor did use a swab for those STD tests I mentioned above. I guess he did not test me for herpes(HSV) then? Otherwise it would have come out in the results.

      I personally dont know much about herpes urethritis. Are the symptoms for this the same as I have?

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    • Posted

      Clinically, the symptoms are not dissimilar to 'typical' urethritis, although the stinging (dysuria) is out of all proportion to the discharge. The other feature is that the meatus (pee hole) is very red and ulceration may be visible; genital ulceration is not a feature of urethritis associated with gonorrhoea, chlamydia or mycoplasma.

      Finally, microscopy of the material (i.e. penile discharge) collected will often show a lymphocytic exudate instead of a polymorphonuclear reaction- in plain language, the white cell response is much more typical of a viral, not a bacterial infection. If you still have a discharge, ask them to look for this as well as taking a viral swab for HSV DNA.

      Rgds,

      Adhari

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    • Posted

      Hello Adhari,

      Yestereday I went to my doctor. He said in order to do a Herpes test I need to have blisters on my penis where fluid pops out. I did told him about my bump/sore right on my meatus but he said that can not be Herpes?

      Then he took a swab of the inside of my urethra and he wants to test for: Lues Igm+ Igg. Now I am not familiair with this STD at all and I cant find anything helpfull on the internet. Do you know maybe what this is?

      He again prescribed doxyxycline to me, now for 10 days 2 tablets a day.

      I am really skeptical about this because I already took 8 days of Doxy 2 tablets a day and nothing happened. Would those 2 extra days have any effect? I really doubt it and I dont want to take those heavy antiobiotics for no reason.

      I am looking forward to your answer.

      Thank you in advance!

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    • Posted

      Hi robert,

      Your doctor is correct that an HSV DNA swab is only useful when you have an outbreak. It doesn't necessarily have to be a big ulcer or fluid oozing out of it! The technology for detection is based on nucleic acid (DNA) amplification, which is incredibly sensitive.

      I'm not sure what type of swab he's taken and you may have misunderstood him.

      • Lues = syphilis. So has he taken a swab to look for syphilis? Maybe a T. pallidum DNA swab on your sore?
      • IgG/IgM = antibodies. That would imply he's taken a (repeat?) blood sample looking for early syphilis (to explain the penile sore)
      • Doxycycline 100mg bd x 10 days

        This suggests he's treating you presumptively for syphilis

      You will realise from what I've written (as you have yourself) that I'm somewhat sceptical about the syphilis diagnosis. I hope I may be proved wrong; but now that you've had the tests and you're taking another 10 days of meds you will just have to wait and see the outcome of these investigations and treatment. If you're not any better after this second course of doxy', I suggest you see another doctor with expertise in sexually transmitted infections. Sorry for being pessimistic.

      Rgds,

      Adhari

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