Persistent Fungal Infections After Urological Surgery: Causes and Solutions

Fungal infection

Hello, a year ago I underwent surgery for liver cancer, and after being discharged, I noticed that during bathing, my glans and foreskin were reddened.
When erect, there were a few small red spots (flat) on the glans.
Initially, I thought it was due to the surgical disinfection, but after a few months, it remained the same.
Later, I also discovered that during intercourse, the foreskin would tear.
I consulted a doctor who said it was nothing serious, just that the skin was a bit thin.
He prescribed medication for eczema and fungal infection, and indeed, the color returned to normal.
However, every few months during intercourse, the foreskin still tears and causes pain.
After an erection, the skin feels slightly prickly, and then the reddening occurs again.
Applying the eczema and fungal medication helps.
This has been ongoing for over a year.
I would like to know why this is happening, what condition it might be, and whether it will get better.
Are there any side effects from frequently using the eczema and fungal medication? Thank you.

Mingru, 50~59 year old female. Ask Date: 2021/04/29

Dr. Cai Zhuorong reply Urology

Recurrent balanitis often necessitates consideration of the presence of diabetes mellitus, and of course, rare skin malignancies should also be taken into account.

Reply Date: 2021/04/29

More Info

Persistent fungal infections after urological surgery can be a complex issue, often influenced by various factors including the surgical procedure itself, the patient's immune response, and the presence of underlying conditions. In your case, the symptoms you describe—redness of the glans and foreskin, pain during intercourse, and the recurring need for antifungal treatment—suggest a possible chronic fungal infection, likely exacerbated by skin irritation or other underlying conditions.

Causes of Persistent Fungal Infections
1. Surgical Impact: Surgical procedures can disrupt the normal flora of the skin and mucous membranes. This disruption can lead to an overgrowth of fungi, particularly if the area becomes moist and warm, which are ideal conditions for fungal proliferation.

2. Skin Irritation: The repeated trauma to the skin during intercourse, especially if the skin is thin or sensitive, can lead to micro-tears. These micro-tears can serve as entry points for fungi, leading to infections.
3. Underlying Conditions: Conditions such as diabetes, immunosuppression, or chronic skin conditions can predispose individuals to fungal infections. If you have any underlying health issues, they could be contributing to your persistent symptoms.

4. Antibiotic Use: If you have been on antibiotics for any reason, they can disrupt the normal bacterial flora, allowing fungi to flourish. This is particularly relevant if you have had recurrent infections that required antibiotic treatment.

Solutions and Management
1. Proper Diagnosis: It is crucial to have a proper diagnosis from a healthcare professional. This may include cultures or skin scrapings to identify the specific type of fungus involved.
2. Topical Treatments: While you have been using antifungal creams, it is essential to ensure that the treatment is appropriate for the specific type of fungal infection. Over-the-counter treatments may not always be effective against all types of fungi.

3. Skin Care: Maintaining proper hygiene and skin care is vital. Ensure that the area is kept dry and clean. Avoid using harsh soaps or products that may irritate the skin further.

4. Avoiding Irritation: Consider using lubricants during intercourse to minimize friction and irritation. If the skin is particularly sensitive, it may be worth discussing with your doctor about potential alternatives or protective measures.

5. Consultation with Specialists: If the problem persists, consulting a dermatologist or a urologist specializing in sexual health may provide additional insights and treatment options. They may recommend a more prolonged course of antifungal therapy or alternative treatments.

6. Monitoring and Follow-Up: Regular follow-ups with your healthcare provider are essential to monitor the condition and adjust treatment as necessary. If you notice any new symptoms or changes, report them promptly.

Potential Side Effects of Long-Term Antifungal Use
While antifungal creams are generally safe, prolonged use can lead to skin irritation or allergic reactions. It is essential to use these medications as directed and under the supervision of a healthcare provider. If you have concerns about long-term use, discuss them with your doctor, who may suggest alternative treatments or a different management strategy.

Conclusion
Persistent fungal infections can be frustrating and challenging to manage, especially after surgical interventions. Understanding the underlying causes and implementing appropriate treatment strategies is crucial for resolution. Regular communication with your healthcare provider will help ensure that you receive the best care tailored to your specific situation. If you have any further questions or concerns, do not hesitate to reach out to your healthcare team.

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