and Treating Long Foreskin Issues: A Urology Guide

Prepuce issues

Doctor, I have a problem with phimosis.
I try to expose the glans to keep it dry, but it still itches and red spots keep appearing.
When the glans is covered, I don't experience pain at the urethral opening, but when it is exposed, it hurts due to friction.
If I pull back the foreskin, I can see white discharge on the urethral opening, along with many small red spots.
The foreskin itself also appears red.
These itchy red spots have been bothering me for a long time; almost every day, my foreskin is red, and the urethral opening is also red.
The red spots reappear after a few days, and I really don't know what to do.
It can't be herpes if it keeps coming back every day, right? If I undergo circumcision, will it prevent recurrence? How should I discuss treatment options with my doctor? Could it be related to a Candida or Trichomonas infection causing this persistent issue? Applying medication doesn't seem to help much.

Joe, 10~19 year old female. Ask Date: 2017/03/13

Dr. Du Shixi reply Urology

A physician must personally examine a patient before administering treatment, prescribing medication, or providing a diagnosis.

Hello: If you have engaged in sexual activity, especially unprotected sex, it is advisable to consult a urologist for an examination (and be sure to explain your situation to the doctor).
If you have no sexual experience, the issue may be due to difficulty in cleaning the foreskin, leading to a skin infection.
Generally, maintaining cleanliness and dryness will often resolve the issue on its own.
After a circumcision, it is also important to keep the area clean and dry; failing to do so may lead to recurrence (though the chances will be somewhat reduced).

Additionally, avoid staying up late, refrain from consuming overly spicy foods, and make sure to dry off after urination—these are actions you can take.
While balanitis is not a major issue, it can be challenging to fully resolve, so patience is required; it may take about two weeks.

[Whether it is a yeast infection or trichomoniasis needs to be diagnosed by a physician; I cannot make a diagnosis casually.] Please do not purchase over-the-counter medications to apply, as some may have side effects.
Thank you for your inquiry.

Reply Date: 2017/03/13

More Info

Long foreskin issues, or phimosis, can lead to a variety of complications, including irritation, infection, and pain during urination. It seems that you are experiencing persistent symptoms such as itching, redness, and the appearance of red spots, which can be quite uncomfortable and distressing. Let's delve into the potential causes and treatment options for your condition.

Understanding the Symptoms
The symptoms you describe—itching, redness, and the presence of white discharge—could be indicative of several conditions. One possibility is a fungal infection, such as candidiasis (commonly known as a yeast infection), which can cause itching and irritation of the glans (the head of the penis) and the foreskin. Another potential cause could be a bacterial infection or a sexually transmitted infection (STI), such as trichomoniasis, which can also lead to similar symptoms.

The fact that you experience pain when the urethral opening is exposed suggests that there may be inflammation or irritation in that area, possibly exacerbated by the friction caused by the foreskin. This can lead to a cycle of discomfort and further irritation.

Treatment Options
1. Topical Treatments: Over-the-counter antifungal creams may help if a yeast infection is suspected. If the condition is bacterial, a topical antibiotic may be necessary. However, it's crucial to consult with a healthcare provider before starting any treatment to ensure it is appropriate for your specific situation.

2. Hygiene Practices: Maintaining good hygiene is essential. Gently cleaning the area with mild soap and water can help reduce irritation. After washing, ensure the area is thoroughly dried, as moisture can promote fungal growth.

3. Avoid Irritants: If you are using any products such as scented soaps, lotions, or lubricants, consider discontinuing their use, as they may be contributing to your symptoms.

4. Consultation with a Urologist: Given the persistence of your symptoms, it would be wise to consult a urologist. They can perform a thorough examination and may recommend tests to rule out infections or other underlying conditions. Discussing your symptoms openly with the doctor will help them understand the severity and frequency of your issues.

5. Circumcision: If conservative treatments do not provide relief, circumcision may be considered. This surgical procedure involves the removal of the foreskin and can alleviate issues related to phimosis and recurrent infections. Many patients find that circumcision resolves their symptoms and improves their quality of life.

6. Follow-Up Care: After any treatment, follow-up appointments are essential to monitor your condition and ensure that symptoms do not recur. If you undergo circumcision, your doctor will provide guidance on post-operative care to promote healing and prevent infection.

Conclusion
In summary, your symptoms of persistent itching, redness, and discomfort around the foreskin and urethral opening warrant a thorough evaluation by a healthcare professional. While there are several potential causes for your symptoms, effective treatment options are available, ranging from topical medications to surgical intervention. It is essential to communicate openly with your doctor about your symptoms and concerns to develop a tailored treatment plan that addresses your specific needs. Remember, early intervention can often lead to better outcomes and improved quality of life.

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