Persistent Redness and Urinary Issues After Circumcision: Seeking Answers

Red glans and incomplete urination?

I had a circumcision last March due to glans inflammation, but after a month of normalcy, it started to become red again.
During the day, there are no issues, but at night, after taking a shower, it flares up—sometimes severely, sometimes mildly.
Applying medication hasn't helped.
Doctors have examined it and said everything looks fine, but it even turns purple at times.
Recently, I've noticed that after urinating, I still have to shake for about 30 seconds, and I can't seem to get completely dry; a few drops still come out, which is quite bothersome.
The doctor said my urine is normal, and for the glans, I have been applying Gentamicin 0.3%.
Is this appropriate? I have a steady girlfriend and am unsure if this could be a fungal infection.
I would appreciate any insights.
Thank you.

A Long, 20~29 year old female. Ask Date: 2015/07/04

Dr. Li Xinyi reply Urology

It is not possible to determine the condition and treatment based solely on your description.
Additionally, it is important to consider whether there is a family history of diabetes.
It is recommended to seek consultation and examination from another specialist for a second opinion.

Reply Date: 2015/07/04

More Info

It sounds like you're experiencing a complex set of symptoms following your circumcision, including persistent redness, changes in urination, and possible discomfort. Let's break down your concerns and explore potential causes and recommendations.

Persistent Redness and Discomfort
After circumcision, it is not uncommon for some individuals to experience redness or irritation around the glans (the head of the penis). This can be due to several factors:
1. Healing Process: The area may still be healing, and sensitivity can persist for several months. If the redness is accompanied by discomfort, it could indicate that the skin is still adjusting post-surgery.

2. Irritation: Friction from clothing, hygiene products, or even sexual activity can lead to irritation. If you are using any soaps or lotions, consider switching to a mild, fragrance-free product to minimize irritation.

3. Infection: While your doctors have indicated that there is no infection, persistent redness could suggest a low-grade infection or inflammation. Conditions such as balanitis (inflammation of the glans) can occur, even after circumcision.

4. Allergic Reaction: Sometimes, an allergic reaction to topical medications or even latex from condoms can cause redness and irritation.

Urinary Issues
The urinary symptoms you describe, such as a splitting stream and difficulty fully emptying your bladder, can be concerning. Here are some potential explanations:
1. Urethral Stricture: Scar tissue from the circumcision could lead to a narrowing of the urethra, which might cause changes in the urine stream. This is something that should be evaluated by a urologist.

2. Post-void Dribbling: This can occur due to pelvic floor muscle weakness or issues with the urethra. It may also be related to how the circumcision altered the anatomy of the penis.

3. Infection: Urinary tract infections (UTIs) can cause changes in urination, including urgency, frequency, and changes in the stream. If you suspect a UTI, a urinalysis would be beneficial.

Recommendations
1. Follow-Up with a Urologist: Given your ongoing symptoms, it would be wise to consult a urologist who specializes in post-surgical complications. They can perform a thorough examination and possibly imaging studies to assess for any anatomical changes or strictures.

2. Consider a Culture Test: If there is a suspicion of a fungal infection (like candidiasis), a culture test can help identify the specific pathogen and guide appropriate treatment.

3. Medication Review: Regarding the use of Gentamicin ointment, while it is an antibiotic, it is essential to use it under the guidance of a healthcare provider. Overuse of topical antibiotics can lead to resistance or further irritation.

4. Hygiene Practices: Ensure that you are practicing good hygiene. After urination, gently pat the area dry to avoid moisture buildup, which can lead to irritation or fungal infections.

5. Monitor Symptoms: Keep track of any changes in your symptoms, including the severity of redness, any discharge, or changes in urination. This information can be helpful for your healthcare provider.

Conclusion
Your symptoms following circumcision warrant further investigation to rule out any underlying issues. Persistent redness and urinary changes can significantly impact your quality of life, and addressing these concerns with a specialist will provide you with the best chance for resolution. Don't hesitate to seek a second opinion if you feel your concerns are not being adequately addressed. Your health and comfort are paramount, and you deserve thorough care and attention.

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