and Managing Glans Pain: Causes and Treatments

Glans pain

Hello Doctor, I have had phimosis since high school, which led to balanitis, and I underwent a circumcision.
It did improve for about a year, but starting in mid-July this summer, I began experiencing pain in my glans (it feels like being pricked).
There are no foreign bodies or discharge present; it's just pure pain, which sometimes does not occur (especially when I just wake up or when lying prone).
Because this symptom has been frequent, I was worried about other diseases and consulted a doctor.
I also had a urinalysis, which came back normal.
The doctor suggested it might just be localized inflammation and prescribed Elomet cream for me to apply.
However, after nearly a month of using it, the painful area seems to have shown no improvement.
I have a history of allergies, and I usually take warm to hot showers.
What could be wrong with my glans?

Han Han, 20~29 year old female. Ask Date: 2014/10/05

Dr. Xu Weikai reply Urology

Hello, I cannot make a judgment.
Generally, for cleaning the glans, it is not recommended to use hot water or any cleaning products such as soap or body wash.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Answers found online should only be used as a reference; if necessary, it is important to visit a medical facility for treatment.
This message is from Dr.
Hsu Wei-Kai, Director of the Urology Department at Taitung Hospital, Ministry of Health and Welfare, who cares about your well-being.

Reply Date: 2014/10/05

More Info

Understanding glans pain, particularly after a history of phimosis and circumcision, can be complex. The pain you are experiencing, described as a sharp or stabbing sensation, can arise from various causes, and it is essential to explore these to determine the most appropriate management strategies.

Possible Causes of Glans Pain
1. Post-Surgical Changes: After circumcision, some individuals may experience sensitivity or discomfort in the glans due to changes in the skin and nerve endings. The glans, previously covered by the foreskin, may become more sensitive to friction or temperature changes.

2. Localized Inflammation: Your doctor mentioned the possibility of localized inflammation. This can occur due to irritation from soaps, detergents, or even friction from clothing. In some cases, inflammation can lead to conditions like balanitis, which is inflammation of the glans.

3. Allergic Reactions: Given your history of allergies, it is plausible that you might be reacting to a product you are using, such as soaps, lotions, or even the Elomet cream itself. Allergic reactions can cause localized pain and discomfort.

4. Nerve Sensitivity: After surgery, the nerves in the area may become hypersensitive. This can lead to episodes of pain that may not correlate with any visible signs of inflammation or infection.

5. Psychological Factors: Anxiety or stress can sometimes manifest as physical symptoms, including pain. If you are worried about your health, this could exacerbate your perception of pain.

6. Underlying Conditions: Although your urine tests came back normal, it is still essential to consider other underlying conditions such as infections (even if not evident in urine tests), skin conditions, or other urological issues.

Management Strategies
1. Topical Treatments: While you have been using Elomet cream, which is a topical corticosteroid, it may not be the most effective treatment if the pain is due to nerve sensitivity or an allergic reaction. Discuss with your doctor the possibility of trying a different topical treatment, such as a hydrocortisone cream or a barrier cream to protect the area.

2. Avoid Irritants: Since you have a history of allergies, it is crucial to identify and avoid any potential irritants. Consider using mild, fragrance-free soaps and avoid hot water during showers, as it can exacerbate sensitivity.

3. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may help alleviate discomfort. However, consult your doctor before starting any new medication.

4. Gentle Hygiene Practices: Ensure that you are practicing gentle hygiene. Avoid scrubbing the area too harshly and allow it to dry completely after washing.

5. Follow-Up with a Specialist: If the pain persists despite these measures, it may be beneficial to consult a urologist or dermatologist specializing in genital conditions. They can perform a more thorough examination and possibly conduct additional tests to rule out other conditions.

6. Psychological Support: If anxiety or stress is a contributing factor, consider speaking with a mental health professional. They can provide strategies to manage anxiety, which may help reduce the perception of pain.

Conclusion
In summary, glans pain can arise from various factors, including post-surgical changes, localized inflammation, allergic reactions, nerve sensitivity, and psychological factors. It is essential to work closely with your healthcare provider to explore these possibilities and develop a tailored management plan. If symptoms persist or worsen, further evaluation by a specialist may be necessary to ensure appropriate treatment and relief.

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