Can Herpes Occur in the Urethra? Urological Pain

Q: Can Herpes Occur in the Urethra? Urological Pain

Hello： 1. <br>If all tests are normal, could pain still be caused by inflammation? It seems unlikely. <br>2. <br>Can herpes occur inside the urethra? Yes, but it is difficult to detect. <br>Some confirmatory tests are very challenging (with suboptimal accuracy and specificity). <

Is it possible for herpes to occur in the urethra?

Hello, doctor.
I am the person who asked question #120588.
I started taking a new antibiotic (Minocycline) last week because the lab report indicated that I was not resistant to it.
I felt good for the first six days and thought I was recovering, but on the morning of the seventh day, I experienced pain while urinating, specifically a sharp pain at a certain point rather than a generalized pain (located on the left side just below the urethral opening).
During my follow-up visit yesterday, the doctor prescribed an additional eight days of Minocycline and Lubejin, stating that this treatment for 15 days would resolve the issue.
However, it has now been two days, and I still experience pain while urinating, although the urinalysis remains normal.
If this is just a previous infection, the tissue should have time to heal, and it shouldn't suddenly worsen like this.
Initially, I had urinary pain, but afterward, it was only occasional sharp pain, and it did not occur during urination.

I have a couple of questions for you, doctor:
1.
If all tests are normal, could the pain still be caused by inflammation?
2.
Is it possible for herpes to occur inside the urethra? If so, can it be detected? I am concerned that even with normal urinalysis, there might be something growing inside the urethra.
Thank you again for your assistance.

Ke Sheng, 30~39 year old female. Ask Date: 2017/03/23

Dr. Du Shixi reply Urology

Hello: 1.
If all tests are normal, could pain still be caused by inflammation? It seems unlikely.
2.
Can herpes occur inside the urethra? Yes, but it is difficult to detect.
Some confirmatory tests are very challenging (with suboptimal accuracy and specificity).
Even blood tests may not definitively confirm the presence of herpes in the urethra.

Reply Date: 2017/03/23

More Info

Herpes can indeed occur in the urethra, although it is less common than other locations such as the genital area or the mouth. The herpes simplex virus (HSV) can infect the urethra, leading to symptoms such as pain during urination, which may be localized to a specific area, as you described. This localized pain can be quite distressing and may mimic other urological conditions.

In your case, you mentioned that you started taking Minocycline for a bacterial infection, and while you initially felt improvement, you began experiencing pain during urination after a week. This could indicate a few possibilities:
1. Post-Infectious Inflammation: Even if your urine tests are normal, inflammation can persist after an infection has been treated. The tissues in the urethra may still be sensitive or inflamed, leading to pain. This is particularly true if the initial infection was significant or if there was any irritation from the antibiotic or other factors.

2. Herpes Infection: As you asked, herpes can indeed affect the urethra. If you have a history of genital herpes or have been exposed to someone with the virus, it is possible that the pain you are experiencing could be related to a herpes infection. Symptoms of urethral herpes may include localized pain, burning during urination, and sometimes lesions or sores in the genital area. Testing for herpes can be done through swabs of any visible lesions or through blood tests that check for antibodies to the virus.

3. Other Urological Conditions: Conditions such as urethritis (inflammation of the urethra), interstitial cystitis, or even a urinary tract infection (UTI) that may not show up in standard urine tests could also be responsible for your symptoms. Urethritis can be caused by various pathogens, including sexually transmitted infections (STIs) like chlamydia or gonorrhea, which may not always be detected in a routine urine test.

To address your specific questions:
1. If tests are normal, could there still be inflammation causing pain? Yes, it is possible for inflammation to persist even when standard tests return normal results. The healing process can take time, and localized pain can occur as tissues recover.

2. Can herpes occur in the urethra? Yes, herpes can infect the urethra, and it can be challenging to diagnose if there are no visible lesions. If you suspect herpes, it is advisable to consult a healthcare provider who can perform the appropriate tests, including a swab if lesions are present or a blood test for HSV antibodies.

Given your ongoing symptoms, it would be prudent to follow up with your healthcare provider. They may consider additional testing for STIs, including herpes, or refer you to a urologist for further evaluation. It is essential to address these symptoms promptly to ensure appropriate treatment and to rule out any serious underlying conditions. In the meantime, maintaining hydration and avoiding irritants (like caffeine or spicy foods) may help alleviate some discomfort.

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