Glans Inflammation: Causes, Symptoms, and Treatments

Inflammation of the glans (glansitis) and incomplete urination?

I had a circumcision a year and a half ago, but it hasn't been very effective.
The mid to distal part of my glans often appears red and feels like it has patches, especially during erections, and there seems to be a layer of membrane.
A few days ago, during an erection, I even noticed some small cuts.
Doctors have said there’s no issue.
I have applied Clotrimazole and Gentamicin 0.3%, but they haven't been effective.
About a month ago, after urinating, I had to shake for a long time, and even after wiping, I still notice one or two drops when I put on my underwear.
I also feel some discomfort in my urethra, and when I consulted a doctor, they mentioned a narrowing of the urethra and prescribed medication.

1.
Could this be a case of candidal balanitis?
2.
What medication should I apply?
3.
Regarding my urination issues (such as urine splitting, although urine tests have shown no problems), what should I do?

Long, 20~29 year old female. Ask Date: 2015/07/08

Dr. Lin Wenxu reply Urology

1.
Could it be a fungal infection? (Or is it necessary to have a physician examine it before making a judgment?) 2.
The most commonly used ointment is Neomycin.
3.
Due to the length of the male urethra, there may still be some residual urine in the urethra after urination, which is why this issue occurs.

Reply Date: 2015/07/08

More Info

Understanding glans inflammation, also known as balanitis, involves recognizing its causes, symptoms, and treatment options. Balanitis can occur in individuals who have undergone circumcision, as well as those who have not. It is characterized by inflammation of the glans (the head of the penis) and can be caused by a variety of factors, including infections, irritants, and underlying medical conditions.

Causes of Glans Inflammation
1. Infections: The most common infectious causes of balanitis include:
- Fungal Infections: Candida (yeast) infections are prevalent, especially in individuals with diabetes or those who are immunocompromised. Symptoms may include redness, swelling, and a white discharge.

- Bacterial Infections: Bacterial infections can also lead to balanitis, often presenting with similar symptoms.

- Sexually Transmitted Infections (STIs): Certain STIs can cause inflammation of the glans.

2. Irritants: Exposure to irritants such as soaps, lotions, or latex from condoms can lead to contact dermatitis, resulting in inflammation.

3. Underlying Conditions: Conditions such as diabetes, psoriasis, or lichen sclerosus can predispose individuals to balanitis.

Symptoms
Symptoms of glans inflammation may include:
- Redness and swelling of the glans
- Itching or burning sensation
- Pain during urination or sexual activity
- Discharge from the penis
- A foul odor
- Difficulty retracting the foreskin (if uncircumcised)

Treatment Options
1. Topical Antifungals: If a fungal infection is suspected, topical antifungal creams such as clotrimazole may be prescribed. However, if you have already used clotrimazole without improvement, it may be necessary to reassess the diagnosis.

2. Antibiotics: If a bacterial infection is suspected, topical or oral antibiotics may be necessary.

3. Steroid Creams: In cases of inflammation due to irritants or dermatitis, topical corticosteroids may help reduce inflammation and discomfort.

4. Hygiene Practices: Maintaining proper hygiene is crucial. Gently cleaning the area with mild soap and water can help prevent irritation.

5. Avoiding Irritants: Identifying and avoiding potential irritants, such as certain soaps or personal care products, can help alleviate symptoms.

Addressing Your Concerns
1. Candida Infection: Based on your description, it is possible that you may be experiencing a yeast infection (candidiasis) of the glans, especially if you notice a white discharge or a burning sensation. However, a definitive diagnosis should be made by a healthcare provider.

2. Topical Treatments: If the antifungal treatment you have used has not been effective, it may be beneficial to consult with a dermatologist or urologist for further evaluation. They may recommend a different antifungal or a combination of treatments.

3. Urinary Issues: The sensation of urine splitting or difficulty fully emptying the bladder can be indicative of a urinary tract issue or urethral stricture. It is essential to follow up with your healthcare provider regarding these symptoms, as they may require further investigation, such as imaging or urodynamic studies.

Conclusion
In summary, glans inflammation can arise from various causes, including infections, irritants, and underlying conditions. It is crucial to work closely with your healthcare provider to determine the underlying cause of your symptoms and to develop an appropriate treatment plan. If symptoms persist or worsen, further diagnostic testing may be necessary to rule out more serious conditions. Always prioritize open communication with your healthcare provider regarding any changes in your symptoms or concerns about your treatment.

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