and Managing Inflammation of the Foreskin: A Patient's Journey

Balanitis

Hello doctor, recently I started using a sex toy and although I used a condom, the toy's opening was too small and I hurriedly forced it in, causing the condom to break.
Since that week, I've noticed red spots in the blood vessels of my foreskin, and sometimes I experience sensitivity, pain, or a burning sensation.
I went to a urologist, who diagnosed it as inflammation and prescribed a neomycin ointment.
I applied it for about a month, and while the pain has subsided, the redness persists, so I stopped using it.
After that, I began to experience sensitivity and pain again, so I visited another hospital.
The doctor diagnosed it as a fungal infection and prescribed an antifungal ointment.
After using it for a day or two, I developed some skin breakdown, which hurt when it came into contact with water, so I returned to the same hospital to see another physician.
He said it was a friction burn and prescribed an eye ointment for me to apply.
As of now, I still have redness and sometimes pain.
I would like to ask the doctor what exactly is going on with my condition?

Aguang, 20~29 year old female. Ask Date: 2015/09/01

Dr. Xu Weikai reply Urology

Hello, after treatment, the epidermis may exhibit different characteristics due to the effects of the treatment or medication, leading to discrepancies between the lesions and the original condition, making diagnosis more challenging.
As for the condition being diagnosed as bacterial-fungal-skin abrasion, that is certainly possible.
Note: Initially, there may have been a bacterial and fungal infection; if the bacterial infection was resolved, the remaining fungal infection could lead to epidermal damage due to an allergic reaction to antifungal medication, which may resemble an external injury.
I recommend that you visit a nearby medical facility for a more detailed examination.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only be used as a reference; it is essential to seek medical attention at a healthcare facility when necessary.
The Ministry of Health and Welfare, Taitung Hospital, cares about you.

Reply Date: 2015/09/01

More Info

It sounds like you've been through quite a journey with your condition, and I appreciate your detailed account of the symptoms and treatments you've experienced. Based on your description, it seems you may be dealing with a combination of inflammation, possible infection, and irritation of the foreskin, which can be quite common after trauma or irritation, especially following the use of sexual toys.

Understanding Your Condition
1. Initial Trauma and Inflammation: The initial incident with the sexual toy and the broken condom likely caused trauma to the sensitive skin of the foreskin. This trauma can lead to inflammation, which is characterized by redness, swelling, and sometimes pain or a burning sensation. The body's natural response to injury is to increase blood flow to the area, which can cause the redness you observed.

2. Infection: After the initial trauma, the area may have become susceptible to infections, including bacterial or fungal infections. Your first doctor diagnosed you with inflammation and prescribed a topical antibiotic (likely Neomycin), which is effective for bacterial infections. However, if the inflammation persisted, it could indicate that the initial treatment was not fully addressing the underlying issue.

3. Fungal Infection: When you visited the second doctor and were diagnosed with a fungal infection, it’s possible that the antibiotic treatment disrupted the natural balance of flora in the area, allowing for a yeast infection to develop. Fungal infections can cause similar symptoms, including redness, irritation, and discomfort.

4. Irritation and Sensitivity: The use of topical medications can sometimes lead to irritation or allergic reactions, especially in sensitive areas. The eye ointment prescribed by the last doctor may not have been suitable for the genital area, leading to further irritation and the symptoms you described.

Recommendations for Management
1. Follow-Up with a Specialist: Given the persistence of your symptoms, it would be wise to follow up with a urologist or a dermatologist who specializes in skin conditions. They can provide a more thorough examination and possibly recommend a different approach to treatment.

2. Avoid Irritants: Until you have a clearer diagnosis, avoid using any products that may irritate the area, including scented soaps, lotions, or any topical medications that have not been specifically prescribed for your condition.

3. Gentle Hygiene: Maintain gentle hygiene practices. Clean the area with mild soap and water, and avoid scrubbing. Pat dry gently after washing.

4. Topical Treatments: If you are experiencing ongoing irritation, a topical corticosteroid cream may help reduce inflammation and redness, but this should only be used under the guidance of a healthcare provider.

5. Monitor Symptoms: Keep track of your symptoms, including any changes in color, pain levels, or discharge. This information can be very helpful for your healthcare provider in determining the best course of action.

6. Consider a Culture Test: If infections are suspected, a culture test can help identify the specific type of bacteria or fungus involved, allowing for targeted treatment.

Conclusion
Your experience highlights the complexities of diagnosing and treating conditions related to inflammation and infection of the foreskin. It's essential to work closely with healthcare providers to find the right treatment plan tailored to your specific situation. Don't hesitate to seek a second opinion if you're not satisfied with the current management plan. Your comfort and health are the top priorities, and there are effective treatments available to help you recover fully.

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