Hi. Late 30s gay male here.
So, some background: I had what I suspect, though am not 100% sure was, a primary outbreak of genital HSV about 7 years ago. If it was an outbreak, it was pretty minor, but a doctor visually diagnosed it. I did a couple follow-up tests that came back negative but they may have been too soon after the OB to be an accurate neg. I chose to not obsess over it and just move on with my life.
Fast-forward more than six years and nothing recurred. Nothing at all, even without the help of an antiviral med.
This past summer (mid-August), I had what seemed like a UTI or STI, though the bacterial STIs were ruled out via testing. Symptoms: Urinary urgency (never feeling "empty") that, after ~5 days, gave way to a couple days of occasional bouts of painful urination. Despite the negative STI test, my doc put me on a course of Bactrim and within a few days the symptoms went mostly away; the only thing I was left dealing with was painful ejaculation. But again, no visible lesions, and I've heard that lesions inside the urethra hurt like *hell*. Nothing I experienced could be considered close to that. I've had non-STI UTIs in the past - I'm a rare male who gets them - so I assumed it was something subclinical or maybe a prostate issue. All told, the ordeal lasted less than 2 weeks.
About 10 weeks after that, so mid-November, I had a minor bout of weird urinary symptoms. Nothing painful, but just that "not empty" feeling and general urgency. I didn't take antibiotics this time and it resolved in a little over a week.
Now I'm ~10 weeks after that, and the symptoms are similar to the November round but even more mild. No painful ejaculation, no burning with urination - just a general weird feeling concentrated more in my bladder/prostate area, not the shaft/urethra. I'm ~5 days after the first symptom: discomfort on urination, at the tip of the urethra just once, then not again. I should note that I have pretty extreme anxiety, so much so that my therapist is wondering if the more mild issues are psychosomatic. Half of me wonders if I started fixating on my genital-area sensations after the first discomfort I noticed and have essentially manufactured this. I know we all have random aches and pains, and when they're in the genital area, we can blow them way out of proportion.
Given the recurrent nature of the issues and the fact that I had a kidney stone about 16 months ago, my doctor is referring me to a urologist for further evaluation. Based on the reading I've done here and elsewhere, I know that HSV certainly can be unpredictable, but what I've read here - largely from Dr. Handsfield - it seems that very minor urinary issues in the absence of visible lesions would seem out of character for HSV. I know you can't say "never, no way" with a virus like this, but it doesn't add up.
I'm wondering if it's possible that this could be something aside from surprise HSV flare-ups. I'm at the age where prostate stuff is a possibility, and I also had a definite kidney stone incident in fall of 2022 that I've always wondered may be a sign of more to come.
Yes, I plan on getting an IGG but I'm just wondering if anyone else who knows more may have some insight here in the interim.
Thanks!