Discomfort During Intercourse: Possible Urological Issues - Urology

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Discomfort during intercourse can be a distressing experience, and it’s important to understand the potential urological issues that may be at play. Based on your description, it seems you are experiencing discomfort primarily in the glans (the head of the penis) during sexual activity, along with a burning sensation when urinating and when retracting the foreskin.
The symptoms you describe could be indicative of a few different conditions, but they are often associated with issues related to the foreskin, such as phimosis or balanitis. Phimosis is a condition where the foreskin cannot be easily retracted over the glans, which can lead to discomfort during sexual activity and may also contribute to urinary symptoms. Balanitis, on the other hand, is inflammation of the glans, which can cause redness, swelling, and discomfort, often exacerbated by poor hygiene or infections.

Your mention of experiencing a burning sensation after ejaculation and during urination suggests that there may be some irritation or inflammation present. This could be due to a few factors, including:
1. Infection: A urinary tract infection (UTI) or sexually transmitted infection (STI) could cause burning sensations during urination and discomfort during intercourse. It's important to rule out these possibilities through appropriate testing.

2. Irritation: Sometimes, irritation can occur due to friction during intercourse, especially if there is insufficient lubrication. This can lead to inflammation and discomfort.

3. Phimosis: If your foreskin is tight and difficult to retract, this could lead to discomfort during sexual activity and may also contribute to the burning sensation you experience after ejaculation.

4. Balanitis: As mentioned earlier, inflammation of the glans can cause discomfort and burning sensations. This can be due to infections, poor hygiene, or skin conditions.

Regarding your question about whether this could be a case of "constricted foreskin" (嵌頓性包皮), it sounds like you may be experiencing symptoms consistent with phimosis, especially given your history of difficulty retracting the foreskin. While circumcision is a common treatment for phimosis, it is not the only option.
Here are some potential approaches to consider:
- Topical Steroids: In some cases, applying a topical steroid cream can help to loosen the foreskin and make it easier to retract. This is often a first-line treatment before considering surgery.

- Gentle Stretching: Gradual and gentle stretching of the foreskin can sometimes help alleviate phimosis. This should be done carefully to avoid injury.

- Hygiene: Maintaining good hygiene is crucial. Ensure that the area is clean and dry, as moisture can lead to irritation and infections.

- Medical Evaluation: Since you have already seen a physician, it may be beneficial to seek a second opinion, especially if you feel uncertain about the recommendation for circumcision. A urologist can provide a thorough evaluation and discuss all available treatment options.

In conclusion, while circumcision is a definitive treatment for phimosis, it is not the only option. It is essential to address any underlying issues, such as infections or inflammation, and to explore less invasive treatments first. Open communication with your healthcare provider about your symptoms and concerns is vital in finding the best approach for your situation. If you continue to experience discomfort or if your symptoms worsen, do not hesitate to seek further medical advice.