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Urology  (Expert Forum)
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Irritable urethra and pain inside tip of penis
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Irritable urethra and pain inside tip of penis

by texan123, Feb 27, 2007 12:00AM
I recently found out that my partner has HSV (don't know type - probably 2) since she had a genital outbreak. I probably have HSV 1 since I get periodic cold sores. 4 weeks after unprotected sex with her, I began to have short instances or irritable urethra and pain at the tip of the penis but inside the opening. The pain feels like pin pricks but not always there - only when I move a certain way or when I get an erection in the middle of the night. The irritation along the urethra is not too noticable and it feels more like a warming sensation. I opened the tip of my penis a bit, I notice what looked like a tiny rash inside with very tiny bumps and little puss but it is at the other end of the opening and I was not able to see everything, I think. It's been about 10 days and it's the same. I had tests for HIV-PCR, Syphilis, Gonhorrea, Chlamydia after 4 weeks of possible exposure and it all came back negative. What can this be? HSV? I am also not sure who to make an appointment with since I don't have a GP. I had some bad experience in the past with a Urologist misdiagnosing Chlamydia for months. Do I see a Dermotologist or Urologist?

by Kevin Pho, MD, Feb 28, 2007 12:00AM
I agree with the testing for STDs.  HSV is possible, but this is an uncommon presentation.  A viral culture, or blood tests looking for HSV serology, can be considered if this is suspected.

I would also evaluate the prostate, including a prostatic massage and subsequent analysis of the prostatic fluid.  A transrectal ultrasound can be done to image the prostate.

If infection has been completely ruled out, you can consider a cystoscopy to rule out anatomical causes like a urethral polyp or stricture.

These options can be discussed with your personal physician.  A second urological opinion can also be considered.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_
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by texan123, Mar 02, 2007 12:00AM
To: Misc. (Urology)
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