Prepuce Issues: Symptoms, Treatments, and When to Seek Help

Prepuce issues

Two weeks ago, I discovered a tear in the foreskin where it connects to the glans, but it doesn't hurt or itch; I just feel a slight burning sensation when urinating.
I visited a urologist two weeks ago, and after a urine test, the doctor didn't say much.
He prescribed a three-day course of anti-inflammatory medication (which causes orange-red urine) and gave me a tube of Fucidin cream to apply twice daily.
The wound hasn't hurt or itched since, but it seems to have darkened, and I'm unsure if it's scabbing.

I later noticed that the coronal sulcus also appears to have a tear or abrasion, and a small section connecting to the glans has turned a deeper purple color.
There are also 1-2 minor areas on the glans that seem to have superficial tears, but they are not prominent and do not hurt or itch.
Additionally, I observed 2-3 small red spots on the foreskin where it connects to the glans on the right side, which seem to be tiny wounds, but they are currently not painful or itchy.
Despite these symptoms, there is no discharge.
What could this condition be? Should I continue using Fucidin, or should I seek a follow-up appointment with a doctor or switch to a different medication? I usually have phimosis, with about one-third of the glans exposed, and the glans can be fully exposed when erect, but the foreskin tends to bunch up around the coronal sulcus.
I'm unsure if this is related.
Furthermore, I haven't engaged in sexual activity for over six months, and since there is no pain or itching, I have no idea when the foreskin was injured.

Xiao Wei, 40~49 year old female. Ask Date: 2017/06/19

Dr. Xu Wencang reply Urology

Visit the outpatient clinic for an examination.

Reply Date: 2017/06/19

More Info

It sounds like you're experiencing some concerning symptoms related to your prepuce (foreskin) and glans (head of the penis). Let's break down your situation and discuss the potential issues, treatments, and when you should seek further medical help.

Symptoms and Initial Observations
From your description, you have noticed:
- A broken skin area where the foreskin connects to the glans.

- A burning sensation during urination.

- Darkening of the skin around the injury, which could be a sign of scabbing or healing.

- Additional areas of concern, including a small purple discoloration and red spots.

Possible Causes
1. Friction or Trauma: The skin in the genital area is sensitive, and friction from activities such as masturbation or even tight clothing can cause micro-tears. This could explain the broken skin and the small red dots you observed.

2. Infection: While you mentioned there is no discharge, the initial burning sensation during urination could indicate a mild infection or irritation. The fact that you were prescribed an anti-inflammatory medication and a topical antibiotic (Fucidin) suggests that your doctor was considering this possibility.

3. Dermatological Conditions: Conditions like balanitis (inflammation of the glans) or posthitis (inflammation of the foreskin) can also cause similar symptoms. These conditions can arise from poor hygiene, irritants, or infections.

4. Phimosis: You mentioned that your foreskin sometimes covers the glans. If the foreskin is too tight, it can lead to irritation and injury, especially during erections.

Treatment and Management
1. Continue Using Fucidin: If your doctor prescribed Fucidin, it is generally advisable to continue using it as directed unless you experience any adverse reactions. This topical antibiotic can help prevent infection while the skin heals.

2. Monitor Symptoms: Keep an eye on the areas of concern. If the redness, burning sensation, or any other symptoms worsen, it would be prudent to seek further medical attention.

3. Hygiene: Maintain good hygiene by gently cleaning the area with mild soap and water. Avoid using harsh soaps or irritants that could exacerbate the condition.

4. Avoid Irritation: Wear loose-fitting underwear and avoid activities that could irritate the area until it heals.

When to Seek Further Help
You should consider scheduling a follow-up appointment with your urologist or a healthcare provider if:
- The burning sensation during urination persists or worsens.

- The skin does not appear to be healing or shows signs of infection (increased redness, swelling, or discharge).

- You develop new symptoms, such as fever or significant pain.

- The discoloration or any lesions do not improve or change in appearance.

Conclusion
While it is reassuring that you do not have pain or itching, the presence of broken skin and discoloration warrants careful monitoring. Continue your prescribed treatment, maintain good hygiene, and do not hesitate to seek further medical advice if your symptoms change or do not improve. Remember, your health is paramount, and it’s always better to err on the side of caution when it comes to potential infections or skin conditions in sensitive areas.

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