prostatitis/doctor visit?

[mjones123]

about 40 days ago i had a hj from a CSW.  she also rubbed her genitals (not very hard, legs closed) across my thigh and possibly scrotum.  almost immediately after 1-3 days at the base of my urethra internally there was some soreness -- when I urinated I think where the urine went into the urethra it was specifically painful that spot. I think this was due to the active hj which stressed/damaged the prostate area/bottom of urethra.  about 7-10 days i developed some anal irritation/tingling/itching and went to see my urologist at 17 days after (i am a 44 year old male and have some history of non-specific protatitis).  he examined the anal area, said not to worry about it, that my prostate was slightly enlarged but nothing to worry about.  about that time 15 - 20 days there started some minor tingling in my buttocks.  Since then I have developed  more tingling/heaviness in buttocks, lower back pain near spine and more widespread (doesnt feel like flank pain, which I have had in the past) which is pretty intense, and lymph node area pain in groin (both).  I also feel occasionally prostate/base urethra occasional irritation (perineum, I guess).  today 40 days after at most times I can feel especially the low back pain, often the lymph node pain, and most times the buttock irritation -- I feel one of these symptoms pretty much all the time I am awake..  at day 20 I had a STD panel including HSV Igg and Igm, all negative.  there are no visible lesions/rash/etc
Questions:
a) could my symptoms be caused by bacterial prostatitis, or other follow on mechnical injury from an active hj which irritated/swelled the prostate area?
b) i plan to test again for HSV at 10 weeks -- is there any point in going to the Dr again prior?  The pain is unpleasant but it isnt going to kill me and given my family situation I would like to wait getting meds until I am sure I have HSV

[mjones123]

thank for the comment most of these symptoms have resolved or diagnosed as something else (fungus for the anal itch)

but I test at 11 weeks and my results were hsv-2 negative and hsv-1 equivocal 0.92 --should I bother testing again or can I assume that my equivocal result is really negative.

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  

STDs are not transmitted by hand-genital contact and no STD causes symptoms like you describe.  They are, however, the sort of symptoms reported by many people with genitally focused anxiety, which seems to me to be the most likely explanation.  To your specific question:

a) I don't see how the sexual events you describe could exacerbate your previous prostatitis or result in bacterial prostatitis.  These are not STDs in any sense and are more appropriate for discussion with your urologist.

b) Based on your symptoms and the nature of the exposure, I would not have recommended testing for HSV.  However, your negative result at 3 weeks is reassuring; over half of new HSV-2 infections give positive blood tests by that time.  Since you have started down that path, you may as well go ahead with the follow-up test later (but I suggest 12 weeks, not 10) -- but you can expect it to remain negative.  (Even if it should turn positive, it would not explain symptoms of this sort.  It would only mean you have an asymptomatic HSV infection plus whatever else is causing your pain and other symptoms.)

You might look up some information about the chronic pelvic pain syndrome (CPPS), which is often triggered by genitally focused anxiety.  Google that term (spell it out) and start your reading with the excellent Wikipedia article and the information provided by the Stanford Univ. Dept of Urology, both of which were near the top of the Google hit list last time I looked.  You may find the symptoms are similar to yours, in which case you should discuss this possibility with your urologist.

In the meantime, you really should be having no STD worries, and you can be quite certain you didn't catch herpes.  So stay mellow as you follow-up with your urologist and await the time for your follow-up HSV test.

Regards--  HHH, MD