Persistent Glans Inflammation: Symptoms and Treatment - Urology

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Persistent glans inflammation, often characterized by symptoms such as ulcers, papules, and discomfort, can be a challenging condition to manage, especially following potential exposure to sexually transmitted infections (STIs). Based on your description, it appears that you have experienced significant symptoms following an episode of unprotected sexual intercourse, leading to a series of medical evaluations and treatments.


Understanding Symptoms
The symptoms you are experiencing, including ulcers and papules on the glans, can be indicative of several conditions, including herpes simplex virus (HSV) infection, which is supported by your elevated IgG levels for HSV-1 and HSV-2. Herpes is known for causing painful lesions, and while it can present with initial outbreaks that may resolve, recurrent episodes can occur, sometimes with varying severity.
The fact that your symptoms have worsened over the past month could be attributed to several factors:
1. Herpes Outbreaks: Herpes can cause recurrent outbreaks, and the severity can vary from one episode to another. If the lesions are indeed due to herpes, they may not necessarily resolve quickly, especially if there are triggers such as stress, illness, or immunosuppression.

2. Secondary Infections: The use of topical medications, while intended to treat the condition, can sometimes lead to secondary infections or irritations, particularly if the skin barrier is compromised.

3. Allergic Reactions: The application of various topical treatments, including the "益四聯乳膏" (which may contain multiple active ingredients), could lead to allergic reactions or contact dermatitis, exacerbating the inflammation.

4. Underlying Conditions: Conditions such as balanitis or other inflammatory skin disorders can also present similarly and may require different treatment approaches.


Treatment Considerations
Given your current treatment regimen, which includes the use of saline soaks and topical medications, it is crucial to ensure that you are following a comprehensive approach:
1. Antiviral Therapy: Since you have been diagnosed with HSV, continuing antiviral medication (like Acyclovir or Valacyclovir) as prescribed is essential. These medications can help reduce the duration and severity of outbreaks.

2. Topical Treatments: While topical antibiotics or corticosteroids may be prescribed, it is important to monitor for any adverse reactions. If the current topical treatment is causing irritation, it may be worth discussing alternatives with your healthcare provider.

3. Hygiene Practices: Maintaining good hygiene is vital. Continue with saline soaks, but ensure that the area is kept clean and dry after treatment to prevent further irritation or infection.

4. Follow-Up Care: Regular follow-ups with your healthcare provider are crucial. If symptoms persist or worsen, further evaluation may be necessary, including potential biopsy or referral to a dermatologist or urologist for specialized care.

5. Avoiding Irritants: Be cautious with any products that come into contact with the affected area, including soaps, lotions, or other topical agents that may cause irritation.


Conclusion
Persistent glans inflammation can be distressing, particularly when linked to sexually transmitted infections. It is essential to work closely with your healthcare provider to monitor your symptoms, adjust treatment as necessary, and ensure that any underlying conditions are addressed. If you notice no improvement or if symptoms worsen, do not hesitate to seek further medical advice. Your health and comfort are paramount, and effective management is possible with the right approach.