Brief Answer: These are probably bacterial ulcers Detailed Answer: Hi Mr. XXXXXXX Thanks for your query. Are the ulcers under the foreskin or, on the shaft just below the head of penis? The penile is very soft and delicate. Abrasions following vigorous sex/masturbation are common, leading to breach of skin. Bacteria, which are normally present over the surface, enter through the breach, cause infection and ulcers. Painless ulcers followed by foul smell indicates bacterial infection. Herpes ulcers are painful and preceded by blister formation. Hence, it is apparently not herpes infection in your case. I would therefore recommend that a swab from the ulcers be taken and subjected to microscopic examination and culture to isolate the causative bacteria. A short course of fluoroquinolones or Azithromycin will cure the infection, as well as, ulcers. Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Dr. Rakesh Karanwal

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Brief Answer: Flare-up of old herpes infection is also possible Detailed Answer: OK. PAINLESS ulcers without preceding blisters formation, go AGAINST the diagnosis of herpes. Further, herpes infection is only transmitted sexually. Your female partner's tests being normal, too tends to exclude herpes infection. The opinion is based purely on the information provided by you. However, a flare-up of an old herpes infection cannot be ruled out. Majority of the people who contact herpes infection, have no or very mild symptoms: they do not even BECOME AWARE OF IT. Once the virus enters through the skin, it travels along nerve paths. It may become dormant (inactive) in the nerves and remain there indefinitely. These dormant viruses become active from time to time. When that happens, the virus travels back along the nerve path to the surface of the skin, where additional virus is shed which cause ulcers on the genitals, with or without preceding blisters formation. The symptoms may occur months or even years after becoming infected. This possibility may be considered if you had had sexual intercourse with ANY other infected partner, weeks, months or years ago. However, if you have been sexually active with the same partner for quite some time, possibility of her being infected cannot be ruled out by routine tests. An infected female, but otherwise having no symptoms, can still transmit herpes infection through sexual intercourse. In such cases, Serological tests of the female partner confirms the diagnosis. If this is the case, you may get a swab test done, which will reveal herpes viruses. Further confirmation can be done by Serological test. Take care Dr. Rakesh Karanwal

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