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Discomfort, irritation inside penis without pain, rashes after sex.

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Dear Doctor, I would like to thank you in advance for the response. I am concerned about having acquired any stds. I would first like to give a brief description of myself, describe my encounter and then proceed to describe symptoms. Me: 26 year old male with a healthy lifestyle and no prior medical history of severe health problems or stds. Encounter: About 9 months ago I had a sexual encounter with a stripper with an unknown sexual background. I had shaved my genital area 1-2 hours before the encounter and had a slight cut towards the base of my penis which i cleaned with alcohol and was not bleeding when I engaged in intercourse. We had unprotected genital rubbing for 30 seconds and then protected vaginal intercourse which lasted a couple minutes. Symptoms: A few days after the encounter I felt there was some tingling in my genital area and frequent urination. There were no signs of lesions, rashes, redness, etc. It did not burn when I urinated (nor was the color of urine abnormal) nor did I feel any pain in the area. I thought I had discharge 2 weeks after the encounter but it may have not been discharge as it occurred after urination and it happened once only. But me being as anxious and scared as I was I went and got shot of chlamdyia and gono with some antibiotics to take care of that. At the 3 week mark I did some std testing and all came back negative (VDRL, Anti-HCV, Herpes Type 2 IgG, etc). Fast forward (9 months post encounter) I had a strange feeling on the tip of my penis head one day (left side) and for five days I have felt my penis head to be slightly irritated (whenever it touched or rubbed against my boxers or pants it felt irritated. I also experienced frequent urination. There was some tingling and hotness in my genital area for a few days but I dismissed it as anxiety as it happened before. I started wearing light loose underwear and pants. The strange feeling on the tip of penis went away for 2 days. A day later I felt a pinch on my penis head and got scared. Nothing else happened that day but also felt like a needle like stab for a few seconds between a testicle and inner thigh when i went to bed that night (happened the following night too). The following day I went out with jeans and had some discomfort in the area. Now (10-11 days in) i feel whenever I play (move, adjust, or fidget with my penis) I feel some discomfort/irritation inside my penis and this pinch 2 more times in 2 days. Again I don't see any lesions, rashes, redness in my genital area. My frequent urination is pretty much decreased. My penis head does not hurt when I squeeze the head. It does not hurt or burn when I urinate. Im just not sure what the problem is. I felt today one time some strange pain 3 inches below my belly button some pain for a couple seconds but it went away after too (it might have been from a certain movement). The genital area looks quite normal except maybe these past two days whenever i pee after waking up the pee hole lips? look pumped but then it goes away. Could this be an STD? Genital Herpes? What do you suggest? I apologize if my description of the situation is long. Thank you.

Category: Sexually Transmitted Diseases(STD)Specialist

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Category: Cosmetic and Plastic Surgeon
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Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
Firstly since you already got the STD panel tested after the encounter, the likely acute conditions would have showed up by then, and since they were negative, you should not worry. Moreover, protected intercourse means, that there is a miniscule chance of acquiring STIs, and this is not a matter of great concern.
Your symptoms at preesent are suggestive of an urethritis and with no exposure to chlamydia or gonorrhoe in the recent past, it is non-specific urethritis. I once again assure you, please do not worry. This could just be from a UTI, and hence I advise a urine routine and urine culture for me to be able to come to a diagnosis. Once you have the reports, please share it with me, and I will help you further.
Best Regards.


Patient replied :

Dear Dr.Kruti,
Thank you for your help and for your answer. I have taken quite some time to respond because I have been waiting for my tests to come out. In addition to the test results, I did not mention last time that I had discharge which was clear sticky jelly-like (some parts that were yellow) whilst sleeping that I noticed on my boxer. First I thought it was just a wet dream but two days after I first contacted you.....it happened again also whilst sleeping and usually i wake up within 15 mins (i believe) of discharging and my penis is always semi erect and i would then proceed to pee.
I went and saw a urologist and he did not see anything unsual with my genital area. He then asked me to do a urine analysis, urine culture, ultrasound for my abdomen and pelvis, and some blood tests. I did those and he did not give me any anti-biotics at the time.
My ultrasound, urine analysis, and blood tests all came back normal (except the rbc count was slighly high and the urologist said it was normal). He said everything is normal. The urine culture also came back negative but before it came out the urologist gave me some antibiotics. Yesterday I took a Rocephin injection (injected after a negative skin test), Gentamycin injection, and Perfalgan. They also gave me Tarivid (200mg) oral pills twice a day for 10 days.
In the morning I noticed some redness on the side of my abdomen (specifically love handle area). Is this a reaction to the anti-biotics one day after taken?
Also since you said my symptons are suggestive of non-specific urethritis (most ive read are sexually related).....is it possible to get this after a protected encounter 9 months after the encounter (ive not had any sexual encounters since)? And since my urine results are all negative could this still be the urethritis you mentioned? Also should I be concerned of this red mark? Is it suggestive of something or just a reaction? Also the results 3- 4 weeks after after my protected encounter with details below:
18-21 days - VDRL: Non-reactive, Anti HCV Total: Non-reactive, Herpes Type II IgG: Negative, Chlamydia Trachomatis DNA: Negative, Neisseria Gonnorheaa DNA: Negative
24-25 days: HIV p24 Ag (by ELFA): Negative, HIV 1 & 2 Ab (by ELFA): Negative
Also at 3 month point I did a HIV saliva swab (did not intend to) that was also negative.
I have attached all documents (results of urine etc conducted recently) and the redness (circle) on the side of my stomach. I really hope to hear from you as I am concerned about this and the level of doctors here in my country is not top notch and im not sure if the urologist gave me the proper anti-biotics.


Hello,
Thank you for the follow-up.
The reports being normal, is an encouraging sign and you definitely do not have any STI.
I would have preferred Cotrimoxazole for you instead of Tarivid, however, since you have taken it already you should continue the course.
Also, yes, it could be because of the antibiotic.
You can take Tab, Claritin and it will settle down.
I can assure you, there is nothing to worry about.
Regards.


Patient replied :

Dear Dr.Kruti, Thank you for your help and answer. Ive completed the 10 day anti-biotic treatment and I dont feel the irritation anymore. I did discharge one more time (also whilst sleeping) on day 5 of the anti-biotics treatment but I can confirm that the discharge was clear jelly like and no yellow. I told this to the urologist and he said it is normal prostate secretion. But 4 times in 3 weeks is slightly unsual when its never happened before? Also Doctor im slightly concerned about this one thing that still is present. Whenever my penis is erect, i feel that the skin is tight and penis head is shiny and tight. Its abnormal. The one thing ive read online where the penis head is shiny when erect is balanitis but not all symptons of balanitis are present for me and im circumcized. Also the skin under my penis head is really wrinkly when flaccid, as if there are small bumps but when you stretch there is nothing. Is this a dermatological problem or should I just forgot about it? I really appreciate your answers, is there a way I can contact you further for other consultations in the future....im willing to pay any fees required.


It is good to hear that your condition has resolved now by antibiotic therapy. You can just ignore the discharge as long you don't have any other symptoms. Also, If there is nor redness or pain you need not worry about balanitis.
Regards


Patient replied :

Dear Dr.Kruti, I want to thank you for all your follow up replies. This is my last follow question... Are there any medical topical creams or over the counter creams (or pills) I can use to help solve this and get my penis looking normal when erect? And any of these symptons im having cant be genital herpes can it? Thank you I appreciate it!


Thank you for the follow-up.
This will need a proper physical examination before I can comment.
I would request you to get it examined by an urologist.


Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Experience: 
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
Dr. Kruti Jobanputra Banodkar and 4 other Medical Specialists are ready to help you

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