Painful Urination Near Glans: Causes and Treatment Options

Q: Painful Urination Near Glans: Causes and Treatment Options

Hello： Discomfort in the urethra with low urine output is often indicative of a urinary tract infection. <br>It is recommended to first conduct a urinalysis. <br>Additionally, if there is a cotton-like appearance in the urine, this can also be assessed through urinalysis, which m

Pain during urination near the glans of the penis?

Dr.
Du: I would like to ask about a previous encounter where I engaged in safe sexual practices, including oral and vaginal intercourse, using condoms throughout.
For about three weeks, I experienced no physical issues (though during this time, I also had unprotected intercourse with my girlfriend, who has not been with anyone else).
After that, I started experiencing pain while urinating, specifically at the urethral opening, but I did not have a fever or discharge.
I would like to know if this could be gonorrhea, non-gonococcal urethritis, or just a general urinary tract infection (I did not hold my urine).
I subsequently visited a urology clinic for a urinalysis, and the doctor suspected a Chlamydia infection (non-gonococcal).
He asked if I wanted to self-pay for Chlamydia medication or start treatment for urethritis.
The following medications were prescribed: 1.
Tetracycline HCL capsules, to be taken orally three times a day; 2.
Panadol (Acetaminophen); 3.
Urodine F.C.
tablets 100 (Phenazopyridine HCL).
After taking the medication for two days, I noticed my throat felt very dry and slightly irritated, and I developed a small sore (0.1mm) under my tongue.
After taking the medication, my urine was orange-red (as indicated in the medication warnings), but my issue is that after finishing the medication, the pain while urinating decreased, yet I am only able to urinate about 200cc despite drinking over 1000cc of water.
Could this affect my kidneys? Should I continue taking this medication? On the first day of taking the medication, the pain was somewhat alleviated, but on the second day, there was still some pain while urinating.
Is it necessary to take medication for non-gonococcal infections? Could this be related to using an unclean towel on the glans? Additionally, I have long experienced some floating, cotton-like particles in my urine, which seem to vary with my fluid intake—less when I drink more, and more when I drink less.
What could these floating particles be?

Ayou, 30~39 year old female. Ask Date: 2019/11/12

Dr. Du Shixi reply Urology

Hello: Discomfort in the urethra with low urine output is often indicative of a urinary tract infection.
It is recommended to first conduct a urinalysis.
Additionally, if there is a cotton-like appearance in the urine, this can also be assessed through urinalysis, which may suggest insufficient hydration or inadequate intake of plain water.
Currently, it is advisable to drink plenty of water while minimizing the consumption of beverages and irritant foods, and to maintain a normal lifestyle.
As for the sore throat with lesions, if this has not occurred before, it is advisable to seek medical evaluation.
Wishing you good health.

Reply Date: 2019/11/12

More Info

Painful urination, particularly localized near the glans, can be a distressing symptom and may arise from various underlying causes. Based on your description, it seems you have experienced painful urination after engaging in sexual activities, and you have undergone some preliminary evaluations and treatments. Let's explore the potential causes and treatment options for your condition.

Potential Causes
1. Urinary Tract Infection (UTI): This is one of the most common causes of painful urination. UTIs can occur in the urethra (urethritis) or bladder (cystitis) and may not always present with fever or discharge. Symptoms can include burning during urination, increased frequency, and urgency.

2. Non-Gonococcal Urethritis (NGU): Given that your doctor suspected Chlamydia (披衣菌), this is a possibility. NGU can occur after unprotected sexual contact and may present with similar symptoms to a UTI but is caused by different pathogens.

3. Gonorrhea: Although you mentioned safe sex practices, if there was any exposure to an infected partner, gonorrhea could still be a concern. It typically presents with more pronounced symptoms, including purulent discharge.

4. Irritation or Allergic Reaction: Sometimes, irritation from soaps, lotions, or even laundry detergents can cause localized pain. Additionally, using non-sterile items (like towels) can introduce bacteria.

5. Urethral Stricture or Injury: If there has been any trauma to the urethra, it could lead to pain during urination.

6. Other Conditions: Conditions like interstitial cystitis or prostatitis could also be considered, especially if symptoms persist despite treatment.

Treatment Options
1. Antibiotics: Since your doctor prescribed Tetracycline, it is essential to complete the full course as directed, even if symptoms improve. This ensures that any bacterial infection is adequately treated.

2. Phenazopyridine (Urodine): This medication is a urinary analgesic that can help relieve pain and discomfort during urination. The orange-red urine is a common side effect and is not harmful.

3. Hydration: Continue to drink plenty of fluids. While you mentioned urinating less than 200cc despite high fluid intake, it’s crucial to stay hydrated. If you experience significant changes in urination patterns or if you cannot urinate, seek medical attention.

4. Follow-Up: If symptoms persist or worsen, it is essential to return to your healthcare provider. They may recommend further testing, such as urine cultures, to identify the specific pathogen causing your symptoms.

5. Avoid Irritants: Until your symptoms resolve, avoid potential irritants such as scented soaps, lotions, or any products that may come into contact with the genital area.

Addressing Your Concerns
- Dry Throat and Oral Lesions: The dry throat and small ulcer you mentioned could be unrelated to your urinary symptoms. However, if they persist, consider discussing them with your healthcare provider.

- Floating Particles in Urine: The "cotton-like" particles you observe could be mucus or cellular debris, which can be normal. However, if you notice changes in color, consistency, or if they are accompanied by other symptoms, it is advisable to consult your doctor.

Conclusion
In summary, painful urination can stem from various causes, and it is crucial to follow your healthcare provider's recommendations closely. Complete the prescribed medications, maintain hydration, and monitor your symptoms. If you experience any worsening of your condition or new symptoms, do not hesitate to seek further medical evaluation. Your health and comfort are paramount, and addressing these symptoms promptly can lead to better outcomes.

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