Urethral Redness and Itching: Possible Causes and Treatments

Mild redness and swelling of the urethral opening may improve with proper care?

Since early August, I have been experiencing scrotal eczema, itching of the foreskin, and red spots on the glans, indicating inflammation.
I have been continuously using a steroid cream (the scrotal eczema has improved).
In early September, I noticed mild redness and swelling at the urethral opening, which is itchy, and the urethra also feels itchy without any discharge.
I visited a major hospital where a doctor suggested it might be an allergy and prescribed tetracycline along with a steroid cream for seven days, but there was no improvement.
I then consulted another doctor at the same hospital who prescribed antihistamines, which provided some improvement, but the symptoms have been fluctuating and persist to this day.
I recently took a non-steroidal anti-inflammatory drug, which provided temporary relief.
What could be the possible causes of this? If I need to return to the hospital, should I tell the doctor what tests I would like to undergo? The urethral opening continues to be itchy and mildly red and swollen, and during severe episodes, the urethra also feels itchy, but there is no pain or discharge.
The daily itching is becoming overwhelming.

Li Yang, 20~29 year old female. Ask Date: 2019/10/17

Dr. Du Mingyi reply Urology

It is important to maintain cleanliness and dryness for balanitis.
You should temporarily stop applying ointments and consider taking a course of antibiotics for one week.

Reply Date: 2019/10/17

More Info

Urethral redness and itching can be distressing symptoms that may arise from various underlying conditions. Based on your description, it seems you've been experiencing symptoms related to balanitis (inflammation of the glans penis), possibly exacerbated by eczema in the scrotal area. The persistent itching and redness at the urethral opening, along with the absence of discharge, suggest that this could be due to a few potential causes.

1. Allergic Reactions: Allergies to soaps, detergents, or even certain fabrics can lead to localized irritation and inflammation. If you have recently changed any personal care products or laundry detergents, this could be a contributing factor.

2. Infections: While you mentioned that there is no discharge, it's still possible to have a mild infection, such as a yeast infection or a sexually transmitted infection (STI), which may not always present with significant discharge. A thorough examination and appropriate testing can help rule out these possibilities.

3. Dermatological Conditions: Conditions like eczema or psoriasis can affect the genital area, leading to symptoms such as redness, itching, and irritation. Since you mentioned a history of scrotal eczema, it’s possible that this condition is also affecting the urethral area.

4. Irritation from Medications: The use of topical steroids and antibiotics can sometimes lead to skin thinning or irritation, which may exacerbate symptoms. If you have been using these treatments for an extended period, it might be worth discussing with your healthcare provider.

5. Other Causes: Conditions such as lichen sclerosus or lichen planus can also cause similar symptoms. These are chronic inflammatory skin conditions that can affect the genital area and may require specific treatments.

Given that your symptoms have persisted despite treatment, it is advisable to return to your healthcare provider for further evaluation. When you visit, it would be beneficial to discuss the following:
- Detailed History: Provide a comprehensive history of your symptoms, including when they started, any triggers you have noticed, and the treatments you have tried.

- Physical Examination: Request a thorough examination of the affected areas to assess for any signs of infection, dermatitis, or other skin conditions.

- Laboratory Tests: Ask about the possibility of urine tests or swabs from the urethral area to check for infections or other abnormalities.

- Referral to a Specialist: If your primary care physician or urologist is unable to determine the cause, consider asking for a referral to a dermatologist who specializes in genital skin conditions.

In the meantime, you may find relief from symptoms by avoiding potential irritants, maintaining good hygiene, and using gentle, fragrance-free products. Over-the-counter antihistamines may help alleviate itching, and non-steroidal anti-inflammatory drugs (NSAIDs) can provide temporary relief from inflammation.

In summary, while your symptoms could stem from a variety of causes, a thorough evaluation by a healthcare professional is essential for accurate diagnosis and effective treatment. Don’t hesitate to advocate for yourself and request the necessary tests to get to the bottom of your symptoms.

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