Prepuce and Glans Issues: Causes and Treatment Options

Prepuce and glans issues?

Hello Doctor: In early February of this year, I experienced recurrent balanitis, which led me to undergo a circumcision in early May.
After July 7, due to work commitments, I engaged in oral sex with a condom.
When I returned home that day, I noticed that my glans was red and itchy.
I went back to the hospital, and they diagnosed it as inflammation, prescribing a topical cream and two small pills, one pink and one white, but there was little improvement.
I then visited a dermatologist, who diagnosed it as eczema and prescribed clobetasol, which provided immediate relief from the itching, although there was still some redness.
However, two days later, I began to experience sharp or stabbing pains.
I stopped the medication and went to a urology clinic, where they diagnosed me with balanitis and prescribed medication along with a small jar of ointment.
The redness and itching have subsided, but I still occasionally feel sharp or stabbing pain (it only hurts when touched).
When I examined my foreskin, I noticed red spots resembling pimples.
The doctor said they were sebaceous cysts, but when I squeeze them, they are painful.
I am now unsure if the pain is coming from the glans itself, the sebaceous cysts, or if I have a kidney issue (referred pain).
Additionally, I have pain in my lower abdomen, which I can't determine if it's from the pubic bone or pelvic area, and pressing on it causes pain.
Given this situation, which specialty should I consult first? Is there a possibility that this could be a sexually transmitted infection?

Niming, 20~29 year old female. Ask Date: 2016/08/01

Dr. Sun Hongshun reply Urology

Hello, you have written in great detail, but the key point is that you are currently suffering from a medical condition, and sexually transmitted infections cannot be ruled out.
It is advisable to seek treatment at a urology clinic as soon as possible.

Reply Date: 2016/08/01

More Info

Understanding issues related to the prepuce (foreskin) and glans (the head of the penis) is crucial for proper diagnosis and treatment. Based on your description, it appears that you have been experiencing a series of complications following your circumcision, including inflammation, itching, and pain. Let's break down the potential causes and treatment options for your symptoms.

Causes of Prepuce and Glans Issues
1. Post-Surgical Complications: After circumcision, it is not uncommon to experience some inflammation or irritation as the area heals. This can manifest as redness, itching, or discomfort. If proper hygiene is not maintained, it can lead to infections.

2. Infections: Bacterial or fungal infections can occur post-surgery, leading to conditions such as balanitis (inflammation of the glans) or posthitis (inflammation of the foreskin). Symptoms typically include redness, swelling, and pain.

3. Dermatological Conditions: Conditions like eczema or psoriasis can also affect the genital area, causing similar symptoms. The mention of "eczema" by the dermatologist suggests that this could be a possibility.

4. Sebaceous Cysts: The "red bumps" you described could be sebaceous cysts, which are generally harmless but can become painful if inflamed or infected.

5. Sexually Transmitted Infections (STIs): While your symptoms may not directly indicate an STI, it is essential to consider this possibility, especially if there was any unprotected sexual contact. Symptoms of STIs can sometimes mimic those of other infections.

6. Referred Pain: The pain in your lower abdomen could be referred pain from the genital area or could indicate a separate issue, such as a urinary tract infection or other urological conditions.

Treatment Options
1. Topical Treatments: If the inflammation is due to a dermatological condition, topical corticosteroids or anti-inflammatory creams (like the one prescribed) can help reduce symptoms. However, if you notice any adverse effects, it is essential to consult your doctor.

2. Antibiotics: If a bacterial infection is suspected, your doctor may prescribe oral antibiotics or topical antibacterial ointments to address the infection.

3. Hygiene Practices: Maintaining proper hygiene is crucial. Gently cleaning the area with mild soap and water can help prevent further irritation or infection.

4. Follow-Up Care: Since you have seen multiple specialists, it may be beneficial to return to a urologist for a comprehensive evaluation. They can perform necessary tests, including swabs or cultures, to determine if an infection is present or if there are other underlying issues.

5. Pain Management: Over-the-counter pain relievers may help alleviate discomfort. However, consult your healthcare provider before taking any new medications.

When to Seek Further Help
If your symptoms persist or worsen, or if you develop new symptoms such as fever, increased pain, or discharge, it is crucial to seek medical attention promptly. A urologist would be the most appropriate specialist to evaluate your symptoms, especially considering your history of circumcision and current concerns.

Conclusion
In summary, your symptoms could stem from a variety of causes, including post-surgical complications, infections, or dermatological conditions. It is essential to maintain open communication with your healthcare providers and follow their recommendations for treatment. If you have concerns about STIs or if your symptoms do not improve, do not hesitate to seek further evaluation from a urologist. Proper diagnosis and treatment are key to resolving your issues and ensuring your overall health.

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