Herpetic Urethritis or something else

[mr-pmt]

So I am a male and about a month ago I had non protected oral and vaginal sex. about 2 weeks later I noticed slight discomfort at the beginning of urinating and some slight redness at the urethral opening. About a week after that (3 weeks post sexual encounter) I had a lot stronger pain with urination and more irritation at the urethral opening. I went to a primary doctor for std tests, which all came back negative (no hsv test), including no white blood cells in urine. After a week of continued urination pain I went to an urgent care and tested again. These tests were the same and this doctor also thought that this seemed nothing like hsv. This doctor, however, prescribed a 7 day course of doxy and gave me a shot of some antibiotic, just in case. After about 3ish days of doxy the urination pain and inflammation definitely decreased (coincidence?), but I continued to notice some white discharge and now blood in my semen (also the ejaculations were painful, with pain in lower abdomen and pelvic area, as well as head of penis, which last about an hour). So I was referred to a urologist who also thought this didn’t seem like hsv and thinks it is a more deeply rooted prostate issue and has now upped my 7 day doxy prescription to 4 weeks. What really sent me over the edge on hsv was that after about a week of the strong urination pain I got an infection in both eyes (auto inoculation?) but the optometrist didn’t think it looked liked hsv (how do you tell?). What is your opinion?

Summary
– at 2 weeks slight discomfort at beginning or urination and redness at urethral opening
– at 3 weeks strong urination pain, start doxy
– at 4 weeks eye conjunctivitis (prescribed steroid/antibiotic drops seem to be helping), significantly decreased urination pain (slight pain at start of urination and slight pain after urination), blood in semen and painful ejaculation, sometimes white discharge inside urethra when I wake up.

I tested for igg hsv 1 and 2 a few years ago, both negative

[mr-pmt]

updates: I saw an ophthalmologist and they also said not ocular herpes and did a better job explaining why. Still taking doxy, after a little over a week all urinary/ejaculation symptoms are gone. I imagine you are going to recommend testing after enough time has passed, I just don’t know what else could have caused this since everything else came back negative.

[Terri Warren]

I am not going to recommend testing, no, given the high rate of false positive results on the IgG test. I strongly suspect that you had a bacterial urethritis since your symptoms are improving vastly with doxy. We are seeing some new bacterial pathogens as sexually transmitted infections and doxy is the recommended treatment. I would strongly advise that you trust the urologist and finish the course of doxy and not worry about HSV in this situation. Obviously, if you develop sores, get them checked out but I’m not worried about HSV at this point

Terri

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