Slightly raised skin around edge of urethral meatus

[checknup]

Greetings Doc,

I'm 27, male, and about 3-4 weeks ago I noticed the skin on the left side of the urethral meatus appears very slightly raised (kind of like a slightly scaly texture, maybe about 2 pencil erasers in size). Although it's only slightly raised, it's fairly distinguishable most of the time. There's also a small "lip" appearance along the edge of the meatus on the same side, which I've never noticed before (at least not so pronounced). Also, I've noticed some clear discharge from the penis for a few weeks that looks very much like pre-ejaculation (completely clear, same consistency), even when I wasn't aroused, but that has seemed to decrease in the last few days. Though when I am aroused, it seems like I'm producing more pre-ejaculation than usual.

I had protected sex with 2 girls in the last 3-4 months, the last one about a month ago. The last encounter was protected, but there was some unprotected rubbing near her anus. The encounter before that was also protected, but the condom slipped off shortly before we were done.  So, I decided to get an STD screening a little over a week ago and everything came back normal (though HPV test was not done). The tests included HIV, Gonorrhea, Syphilis, Chlamydia, and H.Pylori and were done through blood and urine samples.

I've done a ton of research on HPV and other STDs, seen countless pictures, but none appear to really resemble what I'm seeing. Could these symptoms be an indication of a Genital Wart (primary concern)? Or could it likely be something else, considering there's been some clear discharge accompanying it? Also, since this occurred shortly after I last had sex, could the friction/rubbing cause an infection/irritation for this long with these kind of symptoms?

I have another appt. to have this physically checked out (and will opt for an HPV test this time), but it will be with a Female doctor. I would really appreciate a Male doc's viewpoint in the meantime.

Thanks a lot.

[Edward W Hook, MD]

By not worthwhile I am referring to the fact that HPV is widespread (just about everyone has or has had it and gotten over it without therapy) and, as I said, many physicians (including me) would not necessarily recommend treatment even if you had a positive HPV test but no other compelling reason for treatment.  

Regarrding other possiblities, that is really beyond the scope of this forum.  to explore other possibilities, I would recommend consulting a dermatologist.  Sorry.  EWH

[checknup]

Thanks for the quick response, doc.

I'm a little confused by part of your reply though, regarding negative tests for HPV. I haven't been tested for HPV yet, but I understand your point of it not being worthwhile.

If none of these symptoms fit with a typical STD, do they fit with any other possibilities? Any kind of mild infection, possibly involving the prostate or anything else? I'm not too worried after ruling out the "heavy hitters", but I am concerned about having something that could possibly be transmittable (even if it's mild), especially since I would like to continue dating (carefully).

[Edward W Hook, MD]

The variation in the entrance to your urethral meatus that you describe does not fit with any typical STD.  Certainly not HPV   This, one negative examination and negative tests for HPV all suggest that whatever this is (my guess is normal variation) is not an STD of any sort and not something to worry about.    In addition, I would not recommend a test for HPV at this time.  If it is positive that just opens up a can of worms. Unless it is causing symptoms, most doctors would not treat a wart at this location and it is likely to go away by itself.  Believe your doctors and your tests.  EWH