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Sensitive prostate and tingling in mouth after oral intercourse

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Dr. Russ, On Nov 20th, I had mutual unprotected oral sex with another male. This of course was ridiculous and stupid. I wish I could take it back, but cannot. The entire event lasted maybe 10 minutes. I did not ingest semen, but possibly pre-seminal fluid. Within two days, I was experiencing a burning urethra and prostate pain. Within a few more days, I had pain in my testicles. I went to a physician on Nov 30th. He took blood/urine samples for HIV, HSV 1, Hepatitis, Syphilis, Chlamydia, Gonorrhea, etc. All came back negative, but it may have been too soon to detect. On the HSV test, they also performed a PCR test, which was also negative. He prescribed Levaquin 500mg once daily for 10 days. The burning in my urethra has stopped, but my prostate is still sensitive. For the past three or four days, I have had a numb, tingling sensation in my mouth and on my tongue. I have looked closely, but see no blisters on my genitals or in my mouth, though my mouth is sore. On Dec 9th, I went to another lab for another round of blood/urine work 21 days post exposure. In addition to all of the previous tests, I also requested an RNA HIV test. Again, all test results are negative. I am terrified. I still have the numbness in my mouth and the tenderness in my prostate. What are your thoughts on the possibility of being infected but not showing on the blood tests. I am married and have not had sex with my wife since the incident pending everything checks out OK. I want to save my marriage. Please give me your thoughts.

Category: Sexually Transmitted Diseases(STD)Specialist

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Category: HIV- AIDS Specialist
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Hello,

Thank you for choosing DoctorSpring.

Your two current symptoms - sensitive prostate and tingling around the mouth are non specific in this context. These are NOT suggestive of an STD at all. You had two sets of STD tests - including a HIV PCR/Viral load - negative.

I would say this is as good as it can get. All these features are suggestive that you are clear of STD. If it is possible you should consider calling up your male partner to confirm whether he has/had any STD. If negative there you are safe to go.

The tingling and prostate pain should resolve by its own. Sitz bath in mild warm water can help. Masturbation/sex can help if there is prostatic congestion.

Hope this helps
Feel free to ask follouwps
Thank you


Patient replied :

Thanks for your reply. Although I have has two negative blood tests for HSV 1&2, today I have a dark purple spot on my lower lip. I have never had a cold sore in my life but I am scared that this is the start. I am afraid that the herpes virus is causing the tingling of my tongue. It has been 22 days since exposure. No follow up exposure from any source. Is it possible to take that long for the blisters to appear? I have read so much on the Internet that I stay confused. Thank you.


Hello,

Theoretically, yes. It is still possible to get a cold sore after 22 days even after the tests being negative. However I would say probability is very minimal.

There are lot of factors involved in arriving this conclusion. All contacts will never result in HSV transmission. (sometimes only less than 10% of occasions HSV transmission occurs from a + individual). And there are chances that you may never manifest the disease. Adding these factors + your negative tests it is less likely that you will manifest HSV.

But the symptoms - redness + tingling is bit suggestive of cold sores or herpes labials. But it could be just a paranoid reaction from all the stuff you are reading online. I guess you should stop that habit and stay relaxed. See for a week whether the lesion evolves or not. If not, ignore it and carry on with business as usual.

Hope this helps
Feel free to ask followups
Thank you


Patient replied :

Hello,

Theoretically, yes. It is still possible to get a cold sore after 22 days even after the tests being negative. However I would say probability is very minimal.

There are lot of factors involved in arriving this conclusion. All contacts will never result in HSV transmission. (sometimes only less than 10% of occasions HSV transmission occurs from a + individual). And there are chances that you may never manifest the disease. Adding these factors + your negative tests it is less likely that you will manifest HSV.

But the symptoms - redness + tingling is bit suggestive of cold sores or herpes labials. But it could be just a paranoid reaction from all the stuff you are reading online. I guess you should stop that habit and stay relaxed. See for a week whether the lesion evolves or not. If not, ignore it and carry on with business as usual.

Hope this helps
Feel free to ask followups
Thank you


Thank you for the answers. One last question please. I am terrified to hug, kiss, or touch my wife and children. I open cabinets and doors with paper towels. What can I do to protect them if I do have HSV? I am afraid I may be shedding the virus even now. I am about to go crazy with fear.


Patient replied :

You are just getting paranoid for sure. There is one thing you should know - More than 50% adults has HSV infection in system. Sometimes upto 60% are already infected. But most will never manifest the disease. So there is 1 in 2 chance that you or your wife are already infected in the childhood or teenage.

This virus is universally present.1. Nothing you do will prevent its spread. 2. Your HSV tests are negative - so it is highly unlikely that you are infective. Again as I said earlier, it is as good as it can get. As a final step - you may wait 3-4 days to see whether there are blisters in your lips. If none I think everything should go back to normal.

And yes safe sex, always
Wish you good health
Feel free to ask followups
Thank you


One more thought and I will stop. Thanks for your patience. The sores in my mouth and bump on my lip are real. There has also been a several burning on either side of my scrotum and my testicles have been aching. My fear is that the PCR test 10 days post exposure and the antibody test 21 days post exposure were false negative due to the short length of time after exposure. How long should I wait after exposure date for follow up blood work at this point ? I hear of false symptoms occurring due to anxiety but these conditions are unfortunately real. Thank you again.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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