Are painful, acne-type lesions in my urethra a sign of STD?

Question

Hello doctor,

I have a few acne-type small skin color dots inside my urethral opening, which have been causing pain for the last three months. It started with masturbation when I went to pee. After a few minutes, the underwear was stuck with precum inside the pee hole. So I pulled it out, and it started paining and burning while urinating. But still, after three months, there was no pain while urinating, but only pains when the penis is normal, and now my underwear often gets inside the pee hole and causes severe pain. My last sexual contact was six months ago. I had unprotected oral sex for two to three minutes. I got tested after ten days for HIV and VDRL both came negative. The problem started six months ago. Again after 10 to 15 days, I got tested for HSV2 and chlamydia both came negative. I took a full body health check up and all the reports were normal. So can this be a case of STD even after testing negative? I took antibiotics but there are no improvements. I have attached the pictures below.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for your query. If available, you can get the NAAT (nucleic acid amplification test) test for mycoplasma and ureaplasma. However, these viruses may cause urine tube infections and may not be easily detectable. I suggest you do a seven day course of capsule Doxycycline (antibacterial) 100 mg twice daily for seven days. If it does not improve, we may consider it to be herpes virus and treat it accordingly. Please avoid looking into the urethra because the pink and light pink areas may be normal mucosa (attachment removed to protect the patient's identity). If there is a fever or urethral discharge, repeat urethral swabs and tests for gonorrhea.

I hope this has helped you. Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Then we may consider viral urethritis. I suggest you to take capsule Acyclovir (antiviral) 200 mg five times daily for seven days. You can also add tablet Tryptomer (Amitriptyline) 10 mg once daily at bedtime. Tryptomer may cause some sedation in the first few doses, but it has a good effect on urethral burning sensation.

I hope this has helped you. Thank you.