and Treating Persistent Glans Inflammation: A Patient's Journey

Q: and Treating Persistent Glans Inflammation: A Patient's Journey

Yang： Hello. 1. If it is indeed an E. coli infection in the urethra, antibiotics should be used for about 2-3 weeks. 2. For the care of the glans and foreskin, do not use soap, body wash, or any cleaning products, and avoid hot water. In other words, local

Glanitis inquiry again~

Hello Doctor: I would like to report my current condition.
Previously, I was informed that I had balanitis, but after three months, the symptoms have not improved and have progressed to numbness and pain in the glans.
The numbness and pain have even extended to both of my legs.
The situation is still ongoing.
The urologist prescribed painkillers and sleeping pills but did not prescribe antibiotics.
A dermatologist stated that I have glans dermatitis, with severe skin damage and no oil production, advising me to maintain care and not to apply any medications.
Therefore, I have not seen a doctor or taken any medication recently.
The numbness and pain in the glans persist (sometimes at night, the pain is so severe that I cannot sleep).
Urine tests have consistently shown normal results due to the absence of discharge, so I insisted on further testing at the lab, where a swab of the glans revealed the presence of Escherichia coli.
(This has somewhat reassured me because I have undergone numerous tests with no abnormalities, yet the numbness, pain, and balanitis have not improved, leaving me anxious about the undetermined cause.) Should I go to a public hospital now to receive antibiotics? Do I need to apply medication to the glans, or is it sufficient to just take the medication? Additionally, how long does it typically take for Escherichia coli to resolve with antibiotics? Can my condition truly be cured? How long should I continue the medication? Thank you, Doctor.
If this doesn't work, I might just fly to see you!

Yang, 20~29 year old female. Ask Date: 2012/03/12

Dr. Xu Weikai reply Urology

Yang: Hello.
1.
If it is indeed an E.
coli infection in the urethra, antibiotics should be used for about 2-3 weeks.
2.
For the care of the glans and foreskin, do not use soap, body wash, or any cleaning products, and avoid hot water.
In other words, local cleaning should be done with cold water only.
Additionally, after cleaning, applying petroleum jelly locally should effectively help with care and prevent reinfection.
3.
Sometimes, local symptoms can be caused by psychological stress.
In such cases, it is essential to undergo psychological adaptation and accept the situation for improvement.
If one solely believes there is an infection or pain, medication alone will not resolve the issue.
I think your doctor may have thoughtfully prescribed sleep aids with this consideration in mind.
It is even possible that using anxiety-reducing medication could be more effective than pain relievers.
If you want to fly over to see me, that's fine, but it may not provide you with immediate relief.
Start by using petroleum jelly for local care; if all goes well, the itching should subside in about 3-5 days.
Local pain should gradually disappear within 1-2 weeks.
Additionally, if possible, try to minimize the time urine is in contact with the glans or foreskin.
After using the restroom, it is advisable to gently wipe the glans with water or a damp cloth, and then apply petroleum jelly.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses can only serve as a reference; if necessary, it is still important to seek medical care at a healthcare facility.
This response is from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2012/03/12

More Info

Understanding and treating persistent glans inflammation can be a challenging journey for many patients. Your experience with glans inflammation, or balanitis, is not uncommon, and it can be frustrating when symptoms persist despite various treatments. Let's break down your situation and explore the potential next steps.

From what you've described, it seems that you initially presented with symptoms of balanitis, which have now progressed to include numbness and pain in the glans, as well as sensations radiating to your legs. This progression can be concerning and may indicate that the inflammation is affecting not just the surface of the skin but potentially the underlying nerves as well.

You mentioned that you have been prescribed pain relief and sleep medications by your urologist, and that antibiotics were not prescribed. This approach is understandable, especially if there was no clear evidence of a bacterial infection at that time. However, the recent discovery of Escherichia coli (E. coli) during a culture test suggests that there may be an underlying infection contributing to your symptoms.

Next Steps in Treatment
1. Antibiotic Therapy: Given the presence of E. coli, it would be advisable to consult with your healthcare provider about starting a course of antibiotics. The duration of antibiotic treatment can vary, but it typically ranges from 7 to 14 days, depending on the severity of the infection and your overall health. It's essential to follow the prescribed course even if symptoms improve before finishing the medication.

2. Topical Treatments: While your dermatologist has advised against using any topical medications, it may be worth discussing the possibility of using a gentle, non-irritating moisturizer or barrier cream to help protect the skin and maintain hydration. This can be particularly important if the skin has become severely damaged and lacks natural oils.

3. Follow-Up Care: Regular follow-up with your healthcare providers is crucial. If symptoms persist despite antibiotic treatment, further evaluation may be necessary. This could include additional cultures, imaging studies, or even a referral to a specialist in dermatology or infectious diseases.

4. Lifestyle Modifications: In addition to medical treatment, consider lifestyle changes that may help alleviate symptoms. This includes maintaining good hygiene, avoiding irritants (such as harsh soaps or chemicals), and wearing breathable, loose-fitting clothing to reduce friction and moisture buildup.

5. Psychological Support: Chronic pain and discomfort can take a toll on mental health. If you're feeling anxious or overwhelmed, it may be beneficial to speak with a mental health professional who can provide support and coping strategies.

Prognosis
Regarding your question about whether your condition can be cured, many cases of balanitis, especially those caused by infections, can be effectively treated with the right approach. However, the timeline for recovery can vary based on individual factors, including the severity of the inflammation and your overall health.
It's important to remain proactive in your treatment and communicate openly with your healthcare providers about your symptoms and concerns. If you feel that your current treatment plan is not effective, don't hesitate to seek a second opinion or request further evaluations.

In conclusion, while the journey to recovery from persistent glans inflammation can be complex, with the right medical intervention and self-care strategies, there is a good chance for improvement. Please ensure you follow up with your healthcare provider regarding the antibiotic treatment and any other concerns you may have. Your health and comfort are paramount, and it's essential to address these issues comprehensively.

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