Persistent Itching and Sensitivity in the Glans: A Urology Perspective

Itching at the tip of the glans?

Hello Doctor: About two weeks ago, I started experiencing a tingling and itchy sensation at the tip of my glans (it feels like it's at the urethral opening), but it’s not painful.
Sometimes it’s mild, and other times it’s quite sensitive.
To be cautious, I visited a nearby urology clinic for an examination.
The doctor used a flashlight to inspect the area and said there appeared to be no abnormalities.
He asked if I had engaged in sexual activity, and I replied that I had been doing it myself.
The doctor suggested that I might have injured myself by being too vigorous and prescribed an ointment to apply until the itching subsides.
However, a week has passed, and I still experience the tingling and itching sensation.
Additionally, I’ve noticed a slight decrease in my libido, and this itching makes it difficult for me to achieve an erection, resulting in reduced hardness and stamina.
I am a bit worried and would like to ask the doctor: 1.
Is it possible that the doctor misdiagnosed me, or could there be an internal injury that isn’t visible? 2.
Is it really possible that my DIY activities caused these symptoms? 3.
If there was indeed a misdiagnosis, what other conditions could it potentially indicate? Thank you for addressing my concerns.
I understand that my situation may be difficult to assess online, but I am uncertain whether I should schedule a follow-up appointment.
I appreciate your help, thank you!

Liao Xiansheng, 20~29 year old female. Ask Date: 2021/08/26

Dr. Cai Zhuorong reply Urology

If there is risky sexual behavior, sexually transmitted infections should still be considered.
Further examination may include cystoscopy, but abnormalities may not necessarily be detected.
All tests carry a degree of uncertainty, so all diagnoses are merely "more likely," which can sometimes be 50%, 70%, or even 99%.
The correct approach to medical care is to maintain ongoing monitoring and to engage in positive discussions with the physician.

Reply Date: 2021/08/26

More Info

It sounds like you are experiencing persistent itching and sensitivity in the glans, which can be quite concerning. Based on your description, there are several potential factors that could be contributing to your symptoms.
1. Possible Misdiagnosis: While the urologist you consulted did not find any visible abnormalities, it is still possible that there could be underlying issues that are not immediately apparent. Conditions such as balanitis (inflammation of the glans), contact dermatitis (an allergic reaction), or even a yeast infection could cause symptoms like itching and sensitivity. These conditions may not always present with visible signs, especially in the early stages. If your symptoms persist, it would be advisable to seek a second opinion or return to your urologist for further evaluation.
2. Self-Induced Injury: It is indeed possible that vigorous self-stimulation could lead to irritation or micro-tears in the sensitive skin of the glans. This could result in inflammation, leading to the itching and sensitivity you are experiencing. If the urologist suggested that this could be a cause, it is worth considering how you engage in self-stimulation. Gentle techniques and ensuring adequate lubrication can help prevent such injuries in the future.

3. Potential Underlying Conditions: If there is a misdiagnosis, several conditions could be responsible for your symptoms. These include:
- Balanitis: This is an inflammation of the glans, often caused by poor hygiene, infections, or irritants. Symptoms include redness, swelling, and itching.

- Contact Dermatitis: This can occur due to an allergic reaction to soaps, lotions, or even latex from condoms. It can cause itching and irritation.

- Fungal Infections: Yeast infections can affect the genital area and lead to itching and discomfort.

- Sexually Transmitted Infections (STIs): Some STIs can cause symptoms in the genital area, including itching and changes in sexual function. If there is any chance of exposure, it would be wise to get tested.

4. Impact on Sexual Function: The decrease in libido and difficulties with erection and stamina could be linked to the discomfort you are experiencing. Anxiety about the symptoms can also contribute to erectile dysfunction. It is important to address both the physical and psychological aspects of your symptoms.
In conclusion, while your initial consultation did not reveal any obvious issues, the persistence of your symptoms warrants further investigation. It is advisable to follow up with your healthcare provider, discuss your ongoing symptoms, and possibly undergo additional tests or evaluations. Keeping an open line of communication with your healthcare provider is crucial for addressing your concerns effectively. Additionally, consider lifestyle modifications that may help alleviate your symptoms, such as practicing good hygiene, avoiding irritants, and using lubrication during self-stimulation.

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