Unusual Sensation Around the Urethral Opening: What You Should Know

Q: Unusual Sensation Around the Urethral Opening: What You Should Know

Hello： <br>1. <br>Do the initial symptoms of molluscum contagiosum or genital warts present as similar red macules or papules before the appearance of warts? I have had these symptoms for almost a month, and I thought that if it were to develop, it should be more evident during t

There is an unusual sensation near the urethral opening of the glans penis?

Hello, doctor.
At the end of last year and the beginning of this year, I was diagnosed with genital warts and molluscum contagiosum in the pubic area.
After undergoing electrosurgery, I am currently in good recovery status.
However, about 3 weeks to a month ago, I noticed a ring of what feels like hyperplastic skin near the urethral opening, with two small red spots on the edges that seem similar to the ring of hyperplasia.
There are no obvious protrusions, resembling erythema but not very pronounced; it is noticeable when viewed directly.
Initially, it was quite apparent during an erection, as the epidermis and glans appeared different from other areas, but it is harder to see normally.
I previously showed it to a young doctor at a large hospital, who thought it was just normal tissue.
Recently, I have observed that the ring seems to have become more pronounced during erections, but it is neither painful nor itchy, and there are no issues with urination.
The last sexual encounter was three months ago, and I plan to see another urologist soon.
I would like to ask you two questions:
1.
Do the initial symptoms of molluscum contagiosum or genital warts present as similar red spots or slight elevations before the warts appear? Since I have had this symptom for almost a month, I thought that if it were to manifest, it should be quite distinct by now.
2.
I found the term "erythematous papules" online, and since my symptoms are somewhat similar, I am a bit concerned.
What is the incidence rate of this condition? How do general practitioners diagnose it? I worry that it may have a low incidence rate, and some doctors might not consider it, even though I can still feel that the ring of skin is somewhat different.
I have not experienced this condition before.
3.
Does the skin of the glans or penis typically undergo hyperplasia as one ages? If there is hyperplasia, can it be visually apparent? I plan to get checked again in a few days.
Thank you for your guidance.

Niming, 20~29 year old female. Ask Date: 2023/03/06

Dr. Du Shixi reply Urology

Hello:
1.
Do the initial symptoms of molluscum contagiosum or genital warts present as similar red macules or papules before the appearance of warts? I have had these symptoms for almost a month, and I thought that if it were to develop, it should be more evident during this period.
— This requires a physician's examination; it is difficult to determine without the presence of lesions.
2.
I found the term "erythema annulare" online, and since my symptoms are somewhat similar, I am a bit worried.
Is this condition common? How do physicians typically diagnose it? I am concerned that it may be rare, and some doctors might not consider it, even though the symptoms are not obvious.
However, I can still feel that the surrounding skin is somewhat different, and I have not experienced this condition before.
— Based on personal experience, it is rare; please consult a physician for examination.
If it is more pronounced during erection, it is likely that observation is needed first.
3.
Does the skin of the glans or penis undergo hyperplasia as one ages? If there is hyperplasia, is it visually apparent? — It varies from person to person, and there are significant differences based on age and individual constitution; it cannot be generalized.
However, if there are ulcers, warts, or masses, medical attention should be sought.
Wishing you good health.

Reply Date: 2023/03/06

More Info

Unusual sensations around the urethral opening can be concerning, especially following a history of sexually transmitted infections (STIs) such as condyloma (genital warts) and molluscum contagiosum. It's important to approach this situation with caution and seek professional medical advice, as you are already planning to do. Here’s a breakdown of your concerns and some additional information that may help you understand your situation better.

1. Initial Symptoms of STIs: In the case of condyloma or molluscum contagiosum, initial symptoms can vary. Condyloma typically presents as small, flesh-colored or gray growths that can appear on the genital area, but before these warts become visible, there may be subtle changes in the skin, such as redness or irritation. However, these changes are not universally present, and many individuals may not notice any symptoms until the warts become more pronounced. If you are experiencing a ring of altered skin around the urethral opening, it’s essential to have this evaluated by a healthcare professional, as it could be a sign of a recurrence or another condition.

2. Understanding "Proliferative Erythema": The term "proliferative erythema" refers to a condition characterized by a red, raised area of skin that may be indicative of various dermatological issues. While it can be associated with certain infections or inflammatory conditions, it is not a specific diagnosis. The prevalence of conditions that cause similar symptoms can vary widely. A healthcare provider will typically perform a thorough examination, possibly including a biopsy or other diagnostic tests, to determine the exact nature of the skin changes. It’s understandable to feel anxious about the possibility of a serious condition, but many skin changes are benign and can be treated effectively.

3. Age-Related Changes in the Skin: As men age, it is common for the skin on the penis and surrounding areas to undergo changes. This can include thickening or changes in texture, which may be perceived as "growths" or "proliferation." These changes are often benign and can be attributed to normal aging processes, friction, or other non-pathological factors. However, any new or unusual changes should be evaluated by a healthcare provider to rule out any underlying conditions.

In summary, while your symptoms may be concerning, they are not uncommon, especially following a history of STIs. It is prudent to follow up with a urologist or dermatologist who can provide a thorough examination and appropriate diagnostic tests. They will be able to give you a clearer understanding of whether your symptoms are related to a recurrence of a previous infection, a new condition, or simply age-related changes.
In the meantime, it’s essential to monitor any changes in your symptoms, such as increased redness, pain, or changes in urination. Avoid self-diagnosing based on internet searches, as this can lead to unnecessary anxiety. Instead, focus on getting a professional evaluation to address your concerns comprehensively. Remember, early intervention is key in managing any potential issues effectively.

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