Penile Pain and Itching: When to Seek Medical Help

Q: Penile Pain and Itching: When to Seek Medical Help

Winnie： Hello! 1. Yes, it is necessary to see a doctor. A bacterial culture may be needed. Dryness of the glans may be due to excessive cleaning; it is recommended not to use soap or body wash for cleaning, just use cool water. 2. You should keep a record of y

Penile pain and itching?

This process has been a bit lengthy, so I will try to report everything.
I would appreciate it if the doctor could take a look at which stage might have issues or require medical attention.
In early May, I experienced pain on the right side of my penis, with prominent blood vessels.
During my first medical visit, the doctor tested my urine and found no issues.
On my second visit to a different clinic, it was suspected that there might be a fungal infection, and I was prescribed a topical antifungal cream for two weeks.
After two weeks, the pain subsided, and the condition of the blood vessels improved, but sometimes the glans would feel a bit itchy.

I read online that exposing the glans might help improve the condition, so two days ago, while at the office, I kept my penis retracted under the foreskin throughout the day.
When I got home, I found that the glans was completely dry and wrinkled, and the frenulum was painful, but there were no external injuries.
Yesterday, I tried applying the cream again to see if it would improve, but this morning it still felt very dry and rough to the touch.
There is no pain in the urethra when urinating, but I often feel pain near the frenulum.
Additionally, in the afternoon, I experienced itching that seemed to originate from the urethra (I had been drinking a lot of water and urinating frequently, which later improved the symptoms, and now there is no itching for the moment).

Last year, I had a similar episode of glans pain, but everything was normal upon examination at that time, and there were no external issues.
The diagnosis was likely due to excessive stress, which caused psychological pain, leading to several doctors becoming familiar with my case.

I would like to ask:
(1) Given the current symptoms of urethral itching, frenulum pain, and dryness of the glans, is it necessary to see a doctor again? Or is it possible that it will resolve on its own? Would it be better to observe for a while before making a judgment?
(2) If I need to see a doctor, what approach should I take to avoid the impression that my issues are psychological?
(3) Is it necessary to conduct a urine test for the urethral itching? I ask this because I have had three urine tests at a hospital in San Chong, and each time the results were normal (although I drank a lot of water before the last test and urinated several times beforehand, which might affect the results).

(4) Additionally, my foreskin can retract, but the frenulum is a bit tight, and I have previously experienced injuries from stretching it.
The doctor who suspected a fungal infection suggested circumcision if the condition did not improve.
Given my current situation, is circumcision still necessary, or should I continue to observe?

Wei Ni, 20~29 year old female. Ask Date: 2015/05/21

Dr. Xu Weikai reply Urology

Winnie: Hello! 1.
Yes, it is necessary to see a doctor.
A bacterial culture may be needed.
Dryness of the glans may be due to excessive cleaning; it is recommended not to use soap or body wash for cleaning, just use cool water.
2.
You should keep a record of your symptoms for the doctor’s reference.
3.
A urine test or examination of urethral discharge may be required.
4.
Circumcision is only necessary if there is pain.
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; it is essential to seek medical care at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/05/21

More Info

Understanding penile pain and itching can be a complex issue, and it’s important to approach it with a thorough understanding of potential causes and appropriate actions to take. Based on your detailed description, let’s address your concerns systematically.

1. Current Symptoms and Need for Medical Attention
You mentioned experiencing three main symptoms: itching of the urethra, pain in the frenulum, and dryness of the glans. Given your history of similar issues and the fact that these symptoms have persisted or evolved, it is advisable to seek medical attention again. While some conditions can resolve on their own, persistent symptoms, especially those involving pain and discomfort, warrant further evaluation.
The dryness and changes in the appearance of the glans could indicate a number of issues, including irritation, infection, or even a dermatological condition. Since you have already seen multiple doctors and have a history of similar symptoms, it’s crucial to have a healthcare provider assess the current state of your symptoms to rule out any underlying conditions that may require treatment.

2. Communicating with Your Doctor
When visiting a healthcare provider, it’s essential to communicate openly about your symptoms and concerns. You can explain that you have a history of penile pain and that your current symptoms are causing discomfort. It may help to keep a symptom diary, noting when symptoms occur, their severity, and any potential triggers. This information can assist the doctor in understanding your condition better and can help alleviate any concerns about being perceived as having psychological issues.

3. Urinalysis Considerations
Regarding the need for a urinalysis, it can be beneficial, especially if you are experiencing urethral itching. Even though previous tests have shown no issues, symptoms can change, and new infections can develop. If you are concerned about the impact of excessive fluid intake on your urinalysis results, inform your doctor about this during your visit. They may suggest a repeat test or other diagnostic measures, such as a swab of the affected area, to provide a clearer picture of what might be happening.

4. Circumcision Considerations
As for the potential need for circumcision, this is typically considered when there are recurrent infections or significant issues with the foreskin that cannot be managed conservatively. If your frenulum is tight and has caused pain in the past, it may be worth discussing this option with your doctor. However, it’s also possible that with proper care and treatment, you may not need surgery. Your doctor can provide guidance based on your current symptoms and overall health.

Conclusion
In summary, it is advisable to seek medical attention for your current symptoms, especially since they have evolved and are causing discomfort. Open communication with your healthcare provider, including a detailed account of your symptoms and history, will facilitate a more accurate diagnosis and effective treatment plan. Urinalysis may be warranted to rule out infections, and the decision regarding circumcision should be made collaboratively with your doctor based on your specific circumstances. Remember, addressing these symptoms early can help prevent further complications and improve your quality of life.

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