Persistent Symptoms Below the Glans: What to Do After a Month? - Urology

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It sounds like you are experiencing persistent symptoms below the glans, particularly around the frenulum area, which has been itchy for over a month. Given your history of phimosis and previous episodes of balanitis (inflammation of the glans), it’s understandable that you might initially think this is a recurrence of balanitis. However, the symptoms you describe suggest that there may be other underlying issues at play.

The persistent itchiness and the presence of a white substance that accumulates despite regular washing could indicate a few possibilities. One common condition that could cause these symptoms is a fungal infection, such as candidiasis (yeast infection). This is particularly plausible if you have a history of balanitis, as yeast infections can often recur in individuals with a predisposition. The white substance you are noticing could be smegma, which is a combination of dead skin cells, oils, and moisture that can accumulate under the foreskin, especially if there is an underlying infection or irritation.

Another possibility is that you might be experiencing a contact dermatitis, which is an allergic reaction to soaps, detergents, or even the materials of your underwear. This could lead to localized itching and irritation, particularly in sensitive areas.

Given that your symptoms have persisted for over a month, it is important to seek further medical evaluation. Here are some steps you can take:
1. Consult a Urologist: Since you have a history of phimosis and recurrent balanitis, it would be beneficial to see a urologist. They can perform a thorough examination and may recommend tests to rule out infections or other conditions.

2. Consider a Culture Test: If a fungal infection is suspected, a culture test can help identify the specific organism causing the infection. This will guide appropriate treatment.

3. Topical Treatments: While you have been using a topical cream (Mei Kang cream), it may not be sufficient if the underlying cause is different from what it was previously. A doctor may prescribe antifungal or steroid creams depending on the diagnosis.

4. Hygiene Practices: Continue to maintain good hygiene by gently washing the area with mild soap and water. Avoid harsh soaps or products that may irritate the skin further.

5. Monitor Symptoms: Keep track of any changes in your symptoms, including any new developments or if the itchiness worsens. This information can be helpful for your healthcare provider.

6. Avoid Irritants: If you suspect that certain products may be causing irritation, consider switching to hypoallergenic soaps and wearing breathable cotton underwear.

7. Follow-Up: If symptoms persist despite treatment, follow up with your healthcare provider for further evaluation. Persistent symptoms may require more in-depth investigation, such as a biopsy or referral to a dermatologist.

In conclusion, while your symptoms may initially seem like a recurrence of balanitis, the specific location of the itchiness and the nature of the discharge suggest that further evaluation is necessary. It’s crucial to address these symptoms promptly to prevent any potential complications and to ensure that you receive the appropriate treatment.