Multiple Ulcers on the Foreskin: Causes and Concerns

Q: Multiple Ulcers on the Foreskin: Causes and Concerns

Hello： 1) The likelihood of balanitis is high, but sexually transmitted infections cannot be ruled out; a blood test is necessary for confirmation, though it is unlikely to be caused by events in July. <br>2) Any history of unprotected sexual activity poses a potential risk. <br>

Multiple ulcers on the foreskin?

At the beginning of July, while on a flight, I may have accidentally sustained a penile injury due to the seating arrangement, but I didn't think much of it.
On July 12 and 19, I had sexual relations with two partners, using condoms (but not during oral sex).
On July 23, I began experiencing pain symptoms.
I have a history of phimosis and may have accumulated smegma due to not paying special attention to hygiene recently.
Subsequently, I developed small rashes, redness, and multiple small ulcerative symptoms.
Upon inquiring about the sexual history of both partners, they stated that they undergo regular testing and have no sexually transmitted infections (STIs) and do not exhibit any physical discomfort.
I have no other obvious symptoms elsewhere on my body.

I researched and found that syphilis ulcers typically do not cause pain.
However, upon examining the ulcer, there is tenderness and frequent urination.
The ulcer appears somewhat irregular, possibly indicating balanitis.
There are also some suspected small blisters.
Currently, the most significant pain is from the ulcers on the foreskin and glans.
I have already scheduled an appointment with a local clinic but would like to ask the doctor: 1) Is this likely to be balanitis (as I have not experienced this before, I have some confusion)? 2) What are the possible STIs I could be infected with? 3) How can I prevent worsening the infection and what related practices should I follow? I have been experiencing some psychological stress as I will not be able to return home for over a month, and I hope the doctor can clarify these concerns for me.

Mr. Tang, 10~19 year old female. Ask Date: 2019/07/26

Dr. Du Shixi reply Urology

Hello: 1) The likelihood of balanitis is high, but sexually transmitted infections cannot be ruled out; a blood test is necessary for confirmation, though it is unlikely to be caused by events in July.
2) Any history of unprotected sexual activity poses a potential risk.
3) Maintain cleanliness and dryness; do not remain wet after urination.
Please refer to the following risk categories: { Low risk - masturbation { Low risk - mutual masturbation, light kissing, mutual rubbing, sexual activity with condom { Moderate risk - deep kissing, oral sex, withdrawal method { High risk - no protective measures, resulting in wounds or bleeding.

Reply Date: 2019/07/26

More Info

Understanding multiple ulcers on the foreskin can be concerning, especially when accompanied by symptoms such as pain, redness, and swelling. Based on your description, there are several potential causes for the ulcers and associated symptoms, which can include infections, inflammatory conditions, or trauma-related issues.

1. Possible Diagnosis: Balanitis or Balanoposthitis
Balanitis refers to inflammation of the glans (the head of the penis), while balanoposthitis involves inflammation of both the glans and the foreskin. Given your history of phimosis (tight foreskin) and potential neglect in hygiene, it is plausible that you are experiencing balanoposthitis. This condition can lead to symptoms such as redness, swelling, pain, and ulceration, particularly if there is a buildup of smegma (a combination of dead skin cells, oils, and moisture) under the foreskin.
2. Sexually Transmitted Infections (STIs)
Although both of your partners claim to have no STIs, it is still essential to consider the possibility of infections such as herpes, syphilis, or other STIs that can present with ulcerative lesions. Herpes, for example, can cause painful sores, while syphilis may present as painless ulcers (chancre) that can be mistaken for other conditions. Given that you engaged in oral sex without protection, the risk of transmission of STIs, including herpes, is present.
3. Preventing Infection and Managing Symptoms
To prevent worsening of your condition, it is crucial to maintain proper hygiene. Gently clean the area with mild soap and water, ensuring that you retract the foreskin if possible to remove any smegma. Avoid irritants such as scented soaps or lotions. Additionally, refrain from sexual activity until you have been evaluated by a healthcare professional, as this can exacerbate the condition and increase the risk of transmitting any potential infections.

4. Seeking Medical Attention
It is commendable that you have already scheduled an appointment with a local clinic. A healthcare provider will likely perform a physical examination and may recommend tests, including swabs of the ulcers or blood tests for STIs. Early diagnosis and treatment are crucial in managing any underlying infections or inflammatory conditions effectively.

5. Psychological Impact
It is understandable that you are experiencing psychological stress due to your symptoms and the uncertainty surrounding them. Stress can exacerbate physical symptoms, so it may be beneficial to engage in relaxation techniques or seek support from friends or mental health professionals during this time.

In summary, the symptoms you are experiencing could be indicative of balanoposthitis or an STI. It is essential to maintain hygiene, avoid sexual activity until evaluated, and consult a healthcare professional for a thorough assessment and appropriate treatment. Your health and well-being are paramount, and addressing these concerns promptly will help alleviate both physical and psychological distress.

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