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Nurse Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience:  RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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im concerned i may have a urethra infection or possible ST

Customer Question

im concerned i may have a urethra infection or possible STI...
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Su S replied 2 years ago.
Greetings,

What are your symptoms? How long the symptoms are there? Was any test done?



Regards.
Customer: replied 2 years ago.
long story short. i received oral sex unprotected 16 days ago...about 5-7 days later, slight discomfort on penis tip. it would rub against my underwear and bother me a bit like a tender sensitive feeling. NO discharge, NO apparent sores or lesions, NO burning while urinating...

Im more concerned with visual symptoms it seems like their is a patch of extra skin on penis tip. had intercourse with my gf a few nights ago (first time since the oral with other girl) and afterwards patchy skin became redder and the next day was back to "normal", BUT good news it seems as if discomfort is fading....... clamydia and gonorrea tested will know results tomorrow...please bear with me just very anxious and concerned at the moment ...I have pics.
Expert:  Dr. Su S replied 2 years ago.
Please send the picture. Did you get the extra patch examined by doctor?
Customer: replied 2 years ago.
doctor examined down there for about 3 seconds said everything looked normal...i was a bit embarrased and wasnt really specific about the patchy skin i just told him about the discomfort coming from the tip. the patch feels and looks wrinkly extra skin and i know its something that wasnt there because of the redness after sex. wish i wouldve taken a pic then....
Customer: replied 2 years ago.
...
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I hope I can help ease your mind here. Please though understand that online, no one can state anything with certainty; all I can do is offer my best guess based on what you've written...and uploaded.

It is true that a picture says a thousand words, and I see the slight redness to which you refer. Its very hard to say what it could be though online. Its possible that the oral sex irritated your penis; that is easy to do if the womans technique is not the best and her teeth were...rough. Factors against that are the time frame; I think that would have shown sooner had that been the case.

Its possible you may have a very slight fungal or even bacterial infection of the head of the penis called balanitis. Usually we see that in men who are not circumcised, but it can happen in those who are. Balantitis, IF fungal, can be treated by over the counter anti fungal creams. HOWEVER, I do not know 100% that it IS a fungal infection (or even that it is Balantitis). Fungal infections tend to more red, and more spread out.


Balantitis can also be caused by bacteria; if this is the case it would need antibiotic ointments or oral medications (depending on severity).

 

Could this be a very very mild herpes? Herpes simplex is a very common virus' most of America (well, approximately 80%) has been exposed to HSV type 1; and 40% of people have been exposed to genital herpes. Herpes lesions are usually blisters, and often quite painful...but some people have it mildly, so mild they are not even aware of outbreaks. The time frame is there, the incubation period right, so I cant rule that out completely, but I think it very very unlikely from what I see.

 

Here is a helpful website regarding balantitis: http://www.nlm.nih.gov/medlineplus/ency/article/000862.htm

Images of BACTERIAL caused Balantitis: http://www.dermnet.com/Balanitis-Bacterial/

You will see it refers mainly to uncircumcised men; these pictures are of SEVERE cases. Yours if this even is balanitis is VERY mild.

 

I am pleased you got STD testing, and you are getting those results tomorrow. If this discomfort of yours continues, I would suggest getting it re-evaluated. Herpes lesions will fade on their own in a week or so, if this is mild herpes (very unlikely)

 

This is a chart of STDs and their signs and symptoms in both men and women: http://www.fwhc.org/health/std.htm

 

I hope I was able to make you a little more comfortable,

Sincerely,

Susan

Customer: replied 2 years ago.
ok.....i understand you are going by what you see. lets say tomorrow the doc tells me clamydia and gono both negative what do you recommend i do?
see a urologist for further evaluation? you mentioned balintitis...is that an STD? is it contagious? can i be tested for it? before coming on here the closest thing i can come to after doing research myself was just that...either balantitis or urethritis? do you think urethritis is another possibility?do you recommend i also get tested for herpes? i too doubt it may be that theres really no sores or pain, just discomfort esp. when i pick at the skin. it doesnt seem like its going anywhere its been the same for days but i cant stop looking down there it has me so anxious and worriedFrown
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

You are seeing the doctor for your results, thats good. If the doctor tells you tomorrow that both chlamydia and gonorrhea are negative, ask him to look at your penis again. Easier to say than do, but please don't be embarrassed, there is no need to be so. Doctors and health care providers are very used to patients who have concerns.

Fungal balanitis...mild cases...can be treated with OTC anti fungal creams. But as I wrote, I cant say that what you have is balanitis at all. And no, Balanitis is not an STD. It is merely an infection of the penile head, and that can come about by many ways, many non sexual at all. It happens mostly in uncircumcised men because the smegma under the foreskin can get infected if its not kept clean; it becomes a good growth media for germs. But, circumcised men can have it as well.

Urethritis...you are not having any pain when you pee. No burning, no discharge, so while I cant say its not, its not high on my list of probables.

The best herpes tests are cultures of the lesions. For that, you would need to show your doctor what concerns you. I think its unlikely this is herpes, but maybe you are having a very mild case. Blood tests do exist, but they wont help much because they show if you have ever been exposed as they show an antibody level (thats the way the body fights the virus) ...and as I wrote above, most people have been. There are different types of antibodies; IgG and IgM; IgM antibodies are made in new infections and so the presence of IgM can show an infection is one of recent origin.

I don't think you need a urologist just yet...if this does not go away after treatment (and that treatment has to come from your doctor after an in person exam), then you could follow up that way.

I hope that was helpful,
Sincerely,
Susan
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

It is now 3am where I am; I am headed off for the night...so if you had any follow up questions I will be happy to see them and answer them tomorrow.

Good night, and please try not to worry too much about this red area too much.

Sincerely,
Susan
Customer: replied 2 years ago.
Hello again good afternoon. My doctor called me to tell me my results which both came back negative for chlam. and gonno. I made an appt to be seen and reevaluated for tomorrow as i did mention to him the patchy skin this time...I will also ask for a herpes culture test. This is a swab test correct? I will mention balantitis as well... Is there a test for that ?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I am so pleased both tests came back negative, that must be quite a relief for you.
The herpes culture test is a swab test, yes,...and your doctor may look at your red area and say the online nurse was nuts; be warned of that. I think it would be a very unusual presentation for herpes which is usually blisters. But some people can have very mild forms.

Balanitis is more a visual inspection, there is no test really except if it doesn't heal with anti fungal or anti biotics, then you may wish to culture that.

That red area was so small that if it is balanitis, its a very mild case.

Hope that helped,
Sincerely,
Susan
Customer: replied 2 years ago.
I am a bit relieved of the test results but my main concern is herpes. ...Anyhow so are you saying that this is most likely a mild case of herpes? Is that your best guess if you had to take a best guess? If it were herpes you said it would heal within a week or so is that completely healed to normal? Im doubting it and im trying to look at this in a positive way and not be so down...Is it possible this just may be something like a friction burn that may take some time to heal. Something tells me this is some type of fungal thing thats what it mostly looks like ,but what do i know. Please excuse so many questions n concern
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

It could well be a friction burn, or as I wrote before, an issue with the ladys technique. But that usually would show up far sooner, friction or abrasions would show immediately. The thing that makes me think "maybe herpes even though it looks really unlike any herpes lesions Ive seen" is that you said it happened 5-7 days after the encounter, which is about right for the herpes incubation period. And I also know that many people can have mild breakouts, so mild some aren't even aware of it.

A guess is "possible herpes". Likely? I think its not very, but I cant discount the possibility. Yes, herpes lesions if it is herpes heal in about one week or a bit longer...two at the most.

It could be a mild balanitis, and if so, it can be treated by over the counter anti fungal cream. However, if its herpes, it will go away in its time and so you may think you treated balanitis but in fact the herpes just healed.

I suggest since you are so worried to have this looked at. Much of America is positive for herpes simplex. There is no shame in having it.

Sincerely,
Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience: RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
Nurse Susan and 4 other Health Specialists are ready to help you
Customer: replied 2 years ago.
it might have come up a bit sooner than 5-7 days... I was giving an approximatiion anyhow, i will see the doc tomorrow and get tested. Wish me luck. Thnk you for your time is very appreciated
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I had to leave the house, I am sorry I missed your thoughtful and kind reply.
Definitely good luck with your appointment and please let me know what happens.

Thank you,
Sincerely,
Susan
Customer: replied 2 years ago.
Greetings once again... I did as you suggested and went to be reevaluated by my doctor. This time he took his time and checked carefully and told me it looks nothing like an STD that he is very close to 100% sure and not to worry. Well i told him tht i was more than worried and concerned about "possible herpes". He did a culture and swabed it and told me he wouldnt even send it out of it were up to him but for my own concen he did.... And today i received great news that both herpes1 n 2 came back negative. I cant
Express how releived i truly am....
Anyhow back to the next step... Simply " what now ?" my doc told me h only recommended 1 thing which was to use get new underwear he noticed the ones i use were too loose and that boxer briefs should irritate me less because he really thinks thats where this is all coming from some type of friction Burn. I did mention i spoke to an online nurse and i did mention urethritis and balintitis to which he both just kept quiet and nodded his head in a " no" fashion.....
Perhaps he may be right or wrong i dont want to insult his intelligence... But wat im sure of is that this issue was never there and theres def. Something there.... Chlam neg gonno neg herpes neg... Well i got the new underwear im goin to let this subside give it 2 maybe 3 weeks hopefully. Im not sure if abstinence from sex or masterbation is an option for me at the moment but i will krep it at a minimum.....,Wht do u recommend i do next?
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I am SO happy you went and got this evaluated. And I am really not surprised it was negative for herpes, I would have been shocked had it been positive. But the chances were there that it could be, and the timeframe was there....so I had to mention it.

Its possible it may be a friction burn, but why would you develop it now when you have likely been wearing the same underwear for a while. Developing a friction burn 5-7 days after a sexual encounter seems odd...if it was the oral sex, I think you would have seen something far sooner. If you want, go to a drug store and get OTC anti fungal cream, IF this is a very mild fungal balanitis that should treat it. But, the loose underwear is a good idea and cant hurt, and may help as well.

Give the loose underwear and the anti fungal cream a try, for a week or even two, and if it still persists, or worsens, seek a second opinion, and I would suggest a dermatologist (specializes in skin diseases and conditions) rather than a urologist.

Sincerely,
Susan
Customer: replied 2 years ago.
about the friction burn, that is exactly what i said. why would this all of a sudden happen esp. a few days after an encounter? and i actually always wear both loose and briefs on and off ....and as i mentioned before it mightve been sooner i just guessed 5-7 days.....

but anyways yes that is my plan i will seek dermatologist after antifungal cream and approx 2 weeks wait. i already have clotrimazole 1% so


1. would you say that would be considered an antifungal cream?....

2.i know the pics werent the best and like you said in person is much easier to diagnose but is there any other STD in your mind that this may come close to now that gonn. chlam. and herps is out of the question....anything it "just might or could be"....i want to take the possibility out of my head of it still being an STD and being contagious etc....

and

3. if it is NOT an STD lets say it is fungal or bacterial balantitis is it contagious? my gf has been on birthcontrol for quite a while now and we dont really use condoms that is why i ask.


(just a quick note: it seems like the skin is wrinkly and looks like tiny micro-blisters of just skin, plain old skin but in the form of bacteria or fungus like if you were to google bacteria, or if you were to look into a microscope at bacteria. kind of like that, blistery looking, but no pain and not really raised, just inside the skin.......i hope i didnt confuse you there...thanks again)
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

Herpes were the only odd outside possibility that came to my mind. It in no way shape or form looks like a syphilis chancre or anything else. How is your girlfriend? Is she having any odd symptoms?

Yes, clotrimazole would be anti fungal, athletes foot is a fungus and it is OK to put it on your penis. Just try not to get it in your urethra as that could be painful, Id imagine.

It is a good question you ask, is it contagious. Fungal balanitis I would think would be mildly contagious because athletes foot is, even though the two are different fungal organisms. (Balanitis tends to be Candida, athletes foot Tinea) However, we all have yeast organisms on our skin, so it would not be an STD; womens yeast infections are not an STD. At worst, IF this is a fungal balanitis you have, you would be introducing Candida into your girlfriends vagina, but if her vagina's microorganisms are in balance she should be fine and not get a yeast infection herself. If this is a bacterial balanitis, you'd see it worsening on yourself...and again, if her vaginal organisms are in balance she should be OK.

Link here: http://www.intelihealth.com/IH/ihtIH?d=dmtATD&c=510211&p=~br,IHW|~st,333|~r,WSIHW000|~b,*|

I hope that helped,
Sincerely,
Susan
Customer: replied 2 years ago.
no complaints yet from her. will follow up with you soon if that is ok...maybe in 2 -3 weeks....have a nice night. thnk you
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

You also have a great night and of course it is OK to let me know what happens.

Sincerely,
Susan
Customer: replied 2 years ago.
Hello again. Well ive decided to move on to the next step. Since july 5 and for about approximately 1 week, i used clotrimazole 1% cream during the day and TOLNAFTATE 1% at night a few times a day. Theres really not much improvement an its not really getting worse, maybe the slightest bit... Anyhow i am planning to take Ampicillin antibiotics that i can get at a corner store near my home. I dont want to go through the whole referall to see dermatologist and expensive medical bills and office visits and prescription thing right now unless i really have to. Like i mentioned i can get 500mg Ampicilin pills (red and black pills).... I read somewhere its good to treat bacteria and works similiar to Amoxicilan or Penicilin for infections n bacteria..... Should i go on with these antibiotics and if so for how long should i take them for? I will continue to use creams simultaneously but need your advce.. Thanks again...
Expert:  Nurse Susan replied 2 years ago.
Hello JACustomer,

I actually would not suggest taking antibiotics unless you had a known bacterial infection. Antibiotics are not so benign, they can kill off the good bacteria in your gut and cause diarrhea and discomfort. And not all antibiotics work the same; some are geared for gram negative bacteria, some are geared for gram positive bacteria (gram negative and positive refers to how they look on petri dishes under gram staining, and also refers to characteristics they have). So, without knowing if you have an infection, and what type of infection it is, its impossible to say (and illegal as well) for me to suggest you use prescription medicine obtained quasi legally from a corner store.

Antibiotic overuse and misuse also creates the development of antibiotic resistant bacteria; no one wants that.

I understand you don't wish to go through the expense of referral and office visits. But, the over the counter fungal creams should have worked by now if it was a fungus. You should not see worsening, which you are seeing, "maybe the slightest bit" if I am reading you correctly. I think you have done everything you can do, over the counter. I don't at all think taking random anti biotics without your own health care providers involvement is a good idea.

I realize money is tight for you. Here are some web pages with links to low cost clinics: http://www.needymeds.org/free_clinics.taf and http://findahealthcenter.hrsa.gov/Search_HCC.aspx and http://www.pparx.org/en/prescription_assistance_programs/free_clinic_finder

I do think you need to be seen and this evaluated again, since this red area is new, and not getting better. I don't think its something you always had and never noticed until now.; you seem aware of your body.

I hope that helped,
Sincerely,
Susan
Customer: replied 1 year ago.
hello again, hope you remember me. Its been about 2 months since we last spoke. Anyhow ill get right to it. The last time we spoke i was to be seen by a dermatologist so i made an appointment. Litle did i know that the appointment date was right after my 26 bday meaning i would no longer have insurance so i was forced to cancel the appointment. I have applied for massachusetts free health insurance which im pretty sure i am eligible being unemployed and all.... But im still waiting on there approval. The pic i sent you before is the same way it looks now. No change. Not better not worse but there is obvioisly still something there. As soon as i get approved i am going to make an appointment and have it looked at. I have a concern... Its been about 3 months since the oral encounter, and i wanted to know since it hasnt been treated yet, assuming it is bacteria or balinitis or whatever it may be, what am i at risk for? Could it last forever or maybe a very long time?? Just very worried here. Thanks
Expert:  Nurse Susan replied 1 year ago.

Hello JACustomer,

Yes, I remember you, and I am sorry I did not reply to you sooner but I was not on Just Answer recently due to lots of pain (back spasm). If it has been three months, unchanged, maybe it is for you, a normal. I was not considering that before because you were so positive that this was a new change for you. Balanitis, whether from bacterial or fungal causes, would get better or worse on its own. It would not tend to stay exactly the same for so very long.

I am not saying to NOT get it checked. I can not say it is normal, abnormal, or anything in between. But the fact it has stayed so stable makes me wonder if it is something that is normal for you.

Im sorry you are unemployed, that has to be rough given this economy. I hope you can find a new job soon. There are many free and low cost clinics that are set up to provide care for people like you, with no insurance or waiting for it. These really can be quite helpful, and if there is a charge, its usually based on what the patient can afford to pay. Here are web links to find ones near you: . http://www.needymeds.org/free_clinics.taf and http://findahealthcenter.hrsa.gov/Search_HCC.aspx and http://www.pparx.org/en/prescription_assistance_programs/free_clinic_finder

I hope I was able to help,
Sincerely,
Susan

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