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What Causes Irritation On Glans And Urethral Opening After Unprotected Sex?
Question: 6 months ago i had unprotected sex w a girl. Next day i developed slight irritation on glans and urethral opening...didnt think much of it. Almost immediately, glans developed a light pink rash more towards the center and has not gotten better or worse in the last 6 months. Rash is more noticeable when erect, and SLIGHTLY raised. When pulling meatus open to look inside urethra, it is always either bright red or purple/grey. There is a constant slight stinging or burning feeling, especially when rubbed up against shorts. If i touch the bright red or purpleness inside urethra it is EXTREMELY painful (i know its not meant for touching but this is above and beyond). Rash, stinging, and bright red urethra never gets better or worse...always consistent. No pain during urination. No external lesions of any sort ever. Can prostititis cause a pink rash and red inflamed urethra? I have been on cipro (10 days), flagyl, zpak, diflucan. Tried different cortizone and anti fungal creams. Nothing provides any results. Urologist recommended a biopsy both on a sample inside urethra as well as pink rash on glans. What can biopsy possibly find? What are some possible infections we havent thought of?
Brief Answer:
Yeast infection or irritation to penis are possibilities.
Detailed Answer:
Hi, Welcome to HCM.
Thanks for posting your query.
With your presentation of pinkish glans penis with burning feeling and sensations, when it touches clothes and a meatal redness, I hope your problem is still yeast infection only. Only thing is that it had not been tackled properly.
Are you married? Do you resume sexual activities the your partners also should be treated?
Don't wash your genitals with soaps or antiseptic lotions. That would irritate and produce such picture. Your physician has to look for any other predisposing factors exist. It has to be overcome or modified.
Specific diagnosis is to be made with investigations and treat that cause. A shot gun therapy would not be better. Treatment for yeast has to be continued for a month to prevent relapse to you and your partners.
There are some other causes for balanitis (inflammation of glans) Those may be revealed in biopsy.
Dr S.Murugan
Yeast infection or irritation to penis are possibilities.
Detailed Answer:
Hi, Welcome to HCM.
Thanks for posting your query.
With your presentation of pinkish glans penis with burning feeling and sensations, when it touches clothes and a meatal redness, I hope your problem is still yeast infection only. Only thing is that it had not been tackled properly.
Are you married? Do you resume sexual activities the your partners also should be treated?
Don't wash your genitals with soaps or antiseptic lotions. That would irritate and produce such picture. Your physician has to look for any other predisposing factors exist. It has to be overcome or modified.
Specific diagnosis is to be made with investigations and treat that cause. A shot gun therapy would not be better. Treatment for yeast has to be continued for a month to prevent relapse to you and your partners.
There are some other causes for balanitis (inflammation of glans) Those may be revealed in biopsy.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for reply. Would the combo of 2 diflucan pills along with a week of miconazole not treat the yeast infection? None of the physicians (2 dermatologists and 2 urologists) think it is a yeast infection as there is no presence of cauliflower like substance. Do you disagree with their thoughts?
If the diflucan and miconazole is not enough, what is proper treatment?
Also i am circumcised.
I am not married nor do i have a consistent sexual partner at the moment. The few occasions that i had sex in the last few months I wore a condom.
Can you name some other possible causes of ballanitis. I did btw have a urethral swab to which i tested negative to everything they tested for.
If the diflucan and miconazole is not enough, what is proper treatment?
Also i am circumcised.
I am not married nor do i have a consistent sexual partner at the moment. The few occasions that i had sex in the last few months I wore a condom.
Can you name some other possible causes of ballanitis. I did btw have a urethral swab to which i tested negative to everything they tested for.
Brief Answer:
Condom allergy is another possibility
Detailed Answer:
Hi,
Welcome back.
Yeast infection can be presented in different ways.
Combo pack is not the correct choice to treat yeast infection.
Diflucan dosage depends on your body weight and weekly once for 4 weeks along with topical application assure you a total cure from your problem.
Condom allergy also has to be thought.
BXO, Balancers of Zoom, Erythroplasia etc Quiret, circinate balanitis are rare balanitis need biopsy to prove the diagnosis.
Dr Murugan
Condom allergy is another possibility
Detailed Answer:
Hi,
Welcome back.
Yeast infection can be presented in different ways.
Combo pack is not the correct choice to treat yeast infection.
Diflucan dosage depends on your body weight and weekly once for 4 weeks along with topical application assure you a total cure from your problem.
Condom allergy also has to be thought.
BXO, Balancers of Zoom, Erythroplasia etc Quiret, circinate balanitis are rare balanitis need biopsy to prove the diagnosis.
Dr Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
There is no way this is a condom allergy...ive never had any problems and always use condoms...this rare appeared a day after i DIDNT use a condom lol and has not gone away since.
How do we properly diagnose a yeast infection? Should i simply call one of my physicians and ask them to proscribe me more diflucan? I weigh 155 lbs.
What are proper ways to treat BXO, Balancers of Zoom, Erythroplasia etc Quiret, circinate balanitis. Can you please provide exact treatments for each one?
How do we properly diagnose a yeast infection? Should i simply call one of my physicians and ask them to proscribe me more diflucan? I weigh 155 lbs.
What are proper ways to treat BXO, Balancers of Zoom, Erythroplasia etc Quiret, circinate balanitis. Can you please provide exact treatments for each one?
Brief Answer:
wet mount and culture confirm yeast infection
Detailed Answer:
Hi
Welcome back
Yeast infection can be confirmed by a wet mount in 10%KOH in a swab taken from glans or foreskin. Culture in Sabaraud's media also will be confirmatory.
There are no definite treatment for rare balanitis except laser, ccryotherapy or steroids ontrial basis.
If possible, upload the ppicture of your lesion.
Dr Murugan
wet mount and culture confirm yeast infection
Detailed Answer:
Hi
Welcome back
Yeast infection can be confirmed by a wet mount in 10%KOH in a swab taken from glans or foreskin. Culture in Sabaraud's media also will be confirmatory.
There are no definite treatment for rare balanitis except laser, ccryotherapy or steroids ontrial basis.
If possible, upload the ppicture of your lesion.
Dr Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Just uploaded 3 images...in images you can see that glans is light pink towards center leading to meatus...also i did my best to include pic of urethra...its pretty hard with only 2 hands but in the picture you can see it is bight red..if i were to open it up even more it would be purpleish/grey.
As i mentioned there is no foreskin so the doctors should have taken a glans swab to test for yeast? I wonder why they didnt do that...
Do you recommend i request more diflucan and keep applying miconazole? When i did it for a week there was absolutely no improvement.... How many of those balanitis can be caused from a sexual encounter?
As i mentioned there is no foreskin so the doctors should have taken a glans swab to test for yeast? I wonder why they didnt do that...
Do you recommend i request more diflucan and keep applying miconazole? When i did it for a week there was absolutely no improvement.... How many of those balanitis can be caused from a sexual encounter?
Brief Answer:
Change the topical application.
Detailed Answer:
Hi,
Welcome once again.
I saw the pictures uploaded by you. Nothing to get upset.
First of all, I am XXXXXXX that it does not fit with any of the rarer causes of balanitis that I had mentioned and forget about the same. The redness over the glans is not uniform. It is more towards meatus and its surroundings and the base is almost normal. Sometimes Micanazole cream also might have some irritation with some individuals. Apply some cream contains Clotrimazole with steroid. It may be soothing and will clear your problem. Regarding your reddened meatus, it might not be due any pathology. With some superficially situated it may appear like that.
Ignore this.
Increase in Diflucan dose and all is not all necessary for you. Clean regularly with clean and plain water. You will be alright soon.
DR S.Murugan
Change the topical application.
Detailed Answer:
Hi,
Welcome once again.
I saw the pictures uploaded by you. Nothing to get upset.
First of all, I am XXXXXXX that it does not fit with any of the rarer causes of balanitis that I had mentioned and forget about the same. The redness over the glans is not uniform. It is more towards meatus and its surroundings and the base is almost normal. Sometimes Micanazole cream also might have some irritation with some individuals. Apply some cream contains Clotrimazole with steroid. It may be soothing and will clear your problem. Regarding your reddened meatus, it might not be due any pathology. With some superficially situated it may appear like that.
Ignore this.
Increase in Diflucan dose and all is not all necessary for you. Clean regularly with clean and plain water. You will be alright soon.
DR S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Right, the redness absolutely leads to meatus...or is coming from meatus. I tried Clomitrozole for a few days as well...also no changes. Regarding the redness/purpleness inside the meatus...this is a big concern. It has been stinging for 6 months now and as I mentioned if i touch the inside there is an EXTREMELY painful stinging feeling....like it is infected. As i mentioned if i open deeper, it gets darker and more purple and almost looks swollen.
How do i treat this?
How do i treat this?
Brief Answer:
Biopsy from meatal lesion will reveal the cause.
Detailed Answer:
Hi, Welcome back.
If you have a feeling of stinging and painful, that too, for the last six months means Biopsy from the ulcer is the only solution to arrive at the diagnosis. I had two similar cases in which it was turned to be a tuberculous chancre.
As per the suggestion of your Urologist go for a biopsy and confirm the diagnosis.
Dr S XXXXXXX
Biopsy from meatal lesion will reveal the cause.
Detailed Answer:
Hi, Welcome back.
If you have a feeling of stinging and painful, that too, for the last six months means Biopsy from the ulcer is the only solution to arrive at the diagnosis. I had two similar cases in which it was turned to be a tuberculous chancre.
As per the suggestion of your Urologist go for a biopsy and confirm the diagnosis.
Dr S XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Oh wow...is this something that is treatable? Would there be other symptoms that I have this? I contacted the girl who I contracted this from and she "claims" she has no issues...there is a good chance she would lie if it was some simple STD but tuberculosis is a serious condition.
In the 2 similar cases, was the inside of the urethra dark grey/purple? I know in the pic i sent it is bright red, but trust me when i say that if i open it up wider it looks swollen and dark grey/purple.
Can you think of any other possibilities that cause a dark grey/purple ulcer that never gets better or worse, and did not respond to 10 days of cipro, 7 days of flagyl, or 5 days of zpak?
In the 2 similar cases, was the inside of the urethra dark grey/purple? I know in the pic i sent it is bright red, but trust me when i say that if i open it up wider it looks swollen and dark grey/purple.
Can you think of any other possibilities that cause a dark grey/purple ulcer that never gets better or worse, and did not respond to 10 days of cipro, 7 days of flagyl, or 5 days of zpak?
Brief Answer:
Lesions are not fit with any STDs as they persist for six months
Detailed Answer:
Hi,
Welcome to HCM.
Definitely it does not belong to any untreatable balanitis. Moreover it is not fit with any STD condition.
In most occasions women folk were not aware of their problems like STD/TB owing to their anatomy of their genitals.
In genital TB there would not be any other serious symptoms like loss of weight, evening rise of temperature etc. Only endometrial biopsy would reveal the infection in women and often associated with infertility in case of females.
In my two case there were stinging pain and discomfort along with redness over the tip of urinary meatus. If carefully examined they were having one or two very tiny ulcers. With Anti tuberculous treatment they were better. There was no recurrence. But there was no grey/purple thing noticed in my cases.
No other thing came to mind. Probably biopsy may be the answer.
Get well soon.
DR S.Murugan
Lesions are not fit with any STDs as they persist for six months
Detailed Answer:
Hi,
Welcome to HCM.
Definitely it does not belong to any untreatable balanitis. Moreover it is not fit with any STD condition.
In most occasions women folk were not aware of their problems like STD/TB owing to their anatomy of their genitals.
In genital TB there would not be any other serious symptoms like loss of weight, evening rise of temperature etc. Only endometrial biopsy would reveal the infection in women and often associated with infertility in case of females.
In my two case there were stinging pain and discomfort along with redness over the tip of urinary meatus. If carefully examined they were having one or two very tiny ulcers. With Anti tuberculous treatment they were better. There was no recurrence. But there was no grey/purple thing noticed in my cases.
No other thing came to mind. Probably biopsy may be the answer.
Get well soon.
DR S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I agree that a biopsy will likely find the solution...however such an invasive procedure should be treated as a last resort. My goal is to somehow come across a solution without involving a biopsy.
Is there anything that a blood test, semen culture, or another type of swab can find? is there any way of diagnosing/confirming TB other than a biopsy?
Can a bladder infection or prostatitis cause the symptoms that i mentioned? There is no pain with urination though. Can you describe anti tuberculous treatment? oral pills? Shots?
Is there anything that a blood test, semen culture, or another type of swab can find? is there any way of diagnosing/confirming TB other than a biopsy?
Can a bladder infection or prostatitis cause the symptoms that i mentioned? There is no pain with urination though. Can you describe anti tuberculous treatment? oral pills? Shots?
Brief Answer:
In Prostatitis and bladder infection symptoms would not be like yours.
Detailed Answer:
Hi,
Welcome once again.
Prostatitis and bladder infection would not produce such a picture.
This type of tuberculous ulcer is a very very rare possibility. Culture of semen and urethra and swabs from urethra, blood test and Mantouex test could not be conclusive. Biopsy only could confirm the diagnosis.
It is possible in XXXXXXX that after ruling out all the other possibilities, as a benefit of doubt, we can start Anti-tuberculous treatment.
Anti-tuberculous treatment consists of a combination of four drugs as pills for six months. Shots are not necessary in a normal conditions.
Dr S.Murugan
In Prostatitis and bladder infection symptoms would not be like yours.
Detailed Answer:
Hi,
Welcome once again.
Prostatitis and bladder infection would not produce such a picture.
This type of tuberculous ulcer is a very very rare possibility. Culture of semen and urethra and swabs from urethra, blood test and Mantouex test could not be conclusive. Biopsy only could confirm the diagnosis.
It is possible in XXXXXXX that after ruling out all the other possibilities, as a benefit of doubt, we can start Anti-tuberculous treatment.
Anti-tuberculous treatment consists of a combination of four drugs as pills for six months. Shots are not necessary in a normal conditions.
Dr S.Murugan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Is it possible that i have a urethritis that didnt respond to 10 days of cipro or 7 days of flagyl or 5 days of zpak?
If so, what is another possible treatment that is different than the previous mentioned ones?
If so, what is another possible treatment that is different than the previous mentioned ones?
Brief Answer:
Presence of pus cells in urine is an evidence for Urethritis.
Detailed Answer:
Hi,
Welcome to HCM.
The answer for your question is very simple.
If your urine examination under a microscope (routine examination) reveals the presence of pus cells more than 5 in number with or without the presence of RBCs, then it indicates that you have urethritis still, not responded to the treatment you had.
We can not rule out such a possibility. There are better choice of antibiotics for Gonococcal urethritis other than Ciprofloxacin and similarly Chlamydial urethitis also had alternatives apart from Zpack.
If there is no evidence of urethritis in urine examination you can rule out this possibility.
Dr S.Murugan
Presence of pus cells in urine is an evidence for Urethritis.
Detailed Answer:
Hi,
Welcome to HCM.
The answer for your question is very simple.
If your urine examination under a microscope (routine examination) reveals the presence of pus cells more than 5 in number with or without the presence of RBCs, then it indicates that you have urethritis still, not responded to the treatment you had.
We can not rule out such a possibility. There are better choice of antibiotics for Gonococcal urethritis other than Ciprofloxacin and similarly Chlamydial urethitis also had alternatives apart from Zpack.
If there is no evidence of urethritis in urine examination you can rule out this possibility.
Dr S.Murugan
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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