Redness, Swelling, and Itching of the Foreskin

Q: Redness, Swelling, and Itching of the Foreskin

Hello： It is recommended that you visit the Urology outpatient clinic at Changhua Hospital to take care of your health.

Redness, swelling, and itching at the tip of the foreskin?

Hello: I have a condition of phimosis, where the foreskin covers the penis both when erect and flaccid, and I can retract the foreskin (retracting it during an erection causes a feeling of swelling).
However, over the past year, I have frequently experienced symptoms of fissures in the foreskin, which has made normal sexual intercourse difficult.
Initially, the foreskin became red, swollen, and itchy (sometimes accompanied by white discharge).
Later, the tip of the foreskin began to crack, and during sexual intercourse, the glans swelled, causing fissures when retracting the foreskin, resulting in pain! After sexual intercourse, my partner also experiences redness, swelling, itching, and excessive discharge in the genital area.
I have consulted several hospitals regarding this situation! Some doctors said it was a yeast or fungal infection affecting the genital area, while others suggested it was an infection caused by phimosis! They prescribed medications to apply regularly, but none have led to a cure (the symptoms keep recurring), which is very distressing! This condition continues to cause intermittent redness of the glans and foreskin; although sometimes it seems to self-heal if left alone, it can also become itchier at times! I truly do not know how to completely resolve this situation! I would like to consult a professional physician: 1.
Is a circumcision necessary? 2.
If surgery is performed, will health insurance cover it? 3.
Are there any recommended hospitals or doctors in the northern region (including Taipei, Taoyuan, Hsinchu, and Miaoli) who can provide treatment?

Niming, 20~29 year old female. Ask Date: 2014/08/18

Dr. Ding Yuantian reply Urology

Hello: It is recommended that you visit the Urology outpatient clinic at Changhua Hospital to take care of your health.

Reply Date: 2014/08/18

More Info

Redness, swelling, and itching of the foreskin can be indicative of several underlying conditions, particularly in the context of phimosis (tight foreskin) and recurrent infections. Based on your description, it seems you are experiencing a combination of symptoms that could be attributed to both a fungal infection (such as candidiasis) and phimosis, which can lead to inflammation and discomfort.

1. Understanding the Symptoms: The symptoms you describe—redness, swelling, itching, and cracking of the foreskin—are common in cases of balanitis (inflammation of the glans penis) or posthitis (inflammation of the foreskin). These conditions can be caused by various factors, including infections (bacterial or fungal), irritants, or underlying skin conditions. The presence of white discharge and the fact that your partner is also experiencing similar symptoms suggest a possible sexually transmitted infection (STI) or a yeast infection, which can be transmitted during sexual activity.

2. Phimosis and Its Implications: Phimosis can exacerbate these symptoms by preventing proper hygiene and trapping moisture, which can lead to infections. When the foreskin cannot be easily retracted, it creates an environment conducive to the growth of bacteria and fungi. This can lead to recurrent infections, as you've experienced.

3. Treatment Options:
- Topical Treatments: Antifungal creams or ointments may be prescribed to treat any fungal infections, while corticosteroids can help reduce inflammation. However, if these treatments are not effective, it may indicate a more significant underlying issue.

- Circumcision: If phimosis is confirmed and is contributing to your recurrent infections and discomfort, circumcision may be recommended. This surgical procedure involves the removal of the foreskin and can provide a permanent solution to the issues you are facing. It is particularly beneficial for individuals who experience chronic infections or significant discomfort due to tight foreskin.

4. Insurance Coverage: In many healthcare systems, including Taiwan's National Health Insurance (NHI), circumcision may be covered if it is deemed medically necessary, particularly in cases of recurrent infections or phimosis. It is essential to discuss this with your healthcare provider, who can provide documentation to support the medical necessity of the procedure.

5. Seeking Professional Help: Given your ongoing symptoms and the lack of resolution with previous treatments, it is advisable to consult a urologist or a specialist in sexual health. They can perform a thorough examination, possibly including cultures to identify any infectious agents, and recommend the most appropriate treatment plan.
6. Recommended Facilities: In the northern region of Taiwan, hospitals such as National Taiwan University Hospital or Taipei Medical University Hospital have urology departments with specialists who can address these issues. It is advisable to seek a referral or recommendation from your primary care physician to ensure you receive the best possible care.

In conclusion, while topical treatments may provide temporary relief, addressing the underlying issue of phimosis through circumcision could offer a more permanent solution to your recurrent symptoms. It is crucial to have an open discussion with your healthcare provider about your symptoms, treatment options, and any concerns regarding insurance coverage for the procedure.

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