Urological Issues: Pain, Discomfort, and Treatment Options

Q: Urological Issues: Pain, Discomfort, and Treatment Options

Xiao Xiang： Hello, I think your condition is likely caused by urethritis. <br>It is best to take medication according to your physician's instructions, as the efficacy and side effects may vary otherwise. <br>Gonorrhea, which is a sexually transmitted infection, can also cause ur

My little brother is sick... It hurts a lot! It's so distressing!

1.
About six years ago, I developed raised bumps on my scrotum (at that time, I had not engaged in sexual intercourse).
The bumps varied in size, and initially, I thought it was scabies, but after seeing a doctor, he diagnosed it as folliculitis.
I took the medication he prescribed, but it didn't help! Some people also suggested it might be a lipoma.
During the day, it doesn't hurt or itch, but at night while sleeping (especially during deep sleep), it starts to itch, and I end up scratching it.
After I began having sexual intercourse, I have never heard of anyone getting infected from me, so it should not be a sexually transmitted infection.
I wash thoroughly every day; so what could it be? How can I get it treated?
2.
I have seen on television or others that the glans penis is red, but mine appears somewhat whitish.
I have had sexual partners ask me why my glans is white.
Why is that?
3.
A few days ago, I noticed a burning sensation on the glans when urinating; I have to urinate slowly, or it feels very hot.
Occasionally, a yellowish-white sticky fluid comes out (please note it is yellowish-white, not milky white, because when I wipe with tissue, it appears yellowish-white, but it smells somewhat like semen).
Worse still, whether I have an erection from holding in urine or from arousal, there is a sharp pain in the penis, as if it is being torn apart! My foreskin is somewhat long, but I can still pull it back to expose the glans when erect, and I usually clean it properly.
This has never happened before.
Later, I went to Taichung Cheng Ching Hospital for a urine test, and the doctor said it was urethritis.
He prescribed a medication called doxycycline capsules for me to take, two capsules daily for a week.
However, I wanted to recover quickly, so I took three to four capsules daily (after each meal and before bed), not following the prescribed dosage.
Will this affect the effectiveness of the medication? Also, is that medication effective? If I am sure it is urethritis, can I buy over-the-counter medication? Which one should I buy? Given my current situation, how long will it take to recover? Is there a faster way? The pain during erections is really troubling...
4.
Actually, about two weeks before the onset of my symptoms, I had unprotected intercourse with someone, but I didn't tell the doctor.
I suspect it might be gonorrhea, but the doctor said it was urethritis.
What is the difference between the two? Should I go back to see him and clarify what happened two weeks ago?

Xiao Xiang, 20~29 year old female. Ask Date: 2006/11/26

Dr. Xu Weikai reply Urology

Xiao Xiang: Hello, I think your condition is likely caused by urethritis.
It is best to take medication according to your physician's instructions, as the efficacy and side effects may vary otherwise.
Gonorrhea, which is a sexually transmitted infection, can also cause urethritis, and the typical treatment course lasts about 10-14 days.
Self-medicating with over-the-counter drugs is not recommended.
For maintenance, you can drink cranberry juice, about 500cc daily, which may help treat urethritis.
I suggest that you return to your original physician for a consultation and provide a detailed explanation of your symptoms.
Regarding the color issue of the glans, I cannot provide an answer without seeing it; you can ask your physician to evaluate it during your follow-up visit.
Note: The previous folliculitis is unrelated to this episode of urethritis and is not associated with sexually transmitted infections.
Sincerely, Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2006/11/26

More Info

Understanding urological issues can be complex, especially when symptoms overlap or when there is uncertainty about the underlying cause. Based on your description, it seems you are experiencing a variety of symptoms that could be related to different conditions. Let's break down your concerns and address them systematically.

1. Scrotal Bumps and Itching: The bumps you described on your scrotum could be a number of things, including folliculitis (inflammation of hair follicles), sebaceous cysts, or even lipomas (fatty tumors). The fact that they are not painful during the day but become itchy at night could suggest a dermatological issue, possibly exacerbated by sweating or irritation from clothing. It’s important to have a healthcare professional examine these bumps directly, as they can provide a definitive diagnosis and appropriate treatment. If the initial treatment for folliculitis was ineffective, a dermatologist might suggest alternative treatments, such as topical antibiotics or anti-inflammatory medications.

2. Color of the Glans: The appearance of your glans (the head of the penis) can vary significantly among individuals. A white or pale appearance can be normal for some, but it can also indicate conditions such as balanitis (inflammation of the glans) or other dermatological issues. If there are no accompanying symptoms like pain or discharge, it may not be a cause for concern. However, if your partner is questioning it, it might be worth discussing with a urologist for peace of mind.

3. Burning Sensation and Discharge: The burning sensation during urination and the presence of a yellowish-white discharge are concerning symptoms that could indicate a urinary tract infection (UTI) or urethritis. The medication you were prescribed, doxycycline, is typically effective for bacterial infections, including some forms of urethritis. However, taking more than the prescribed dose does not necessarily enhance effectiveness and could increase the risk of side effects. It’s crucial to follow the prescribed dosage. If you suspect you have a UTI or urethritis, self-medicating with over-the-counter antibiotics is not advisable, as this can lead to complications or antibiotic resistance. Instead, it’s best to follow up with your healthcare provider to ensure proper treatment.

4. Possible STI Concerns: You mentioned having unprotected sex shortly before your symptoms began, which raises the possibility of a sexually transmitted infection (STI), such as gonorrhea or chlamydia. While your doctor diagnosed you with urethritis, it’s important to communicate your recent sexual history to your healthcare provider. STIs can present with similar symptoms, and a proper diagnosis often requires specific testing. If you have concerns about STIs, it’s essential to be open with your doctor so they can provide the appropriate tests and treatments.

In summary, it’s crucial to have open communication with your healthcare provider about all your symptoms and any recent sexual activity. This will help them make a more accurate diagnosis and provide the best treatment options. If your symptoms persist or worsen, or if you develop new symptoms, do not hesitate to seek further medical attention. Remember, early intervention can often lead to better outcomes in managing urological issues.

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