Urinary Symptoms: Infection or Something Else?

Medical consultation, I am currently abroad and concerned about communication issues... I hope the doctor can provide me with advice?

Hello Doctor, I started feeling the urge to urinate three days ago, and then the next day I began to experience intermittent pain in my bladder.
I went to see a doctor who performed a physical examination and said it was likely an infection, not a sexually transmitted disease.
He prescribed medication, and after three days, I am feeling better.
However, I still have a slight urge to urinate.
There is a small red spot on my glans that looks different from the surrounding skin, but it’s not a pimple.
Is this an infection or something else? Doctor, considering that I haven't had sexual intercourse in two months and two weeks, what sexually transmitted diseases can be ruled out?

Jason, 20~29 year old female. Ask Date: 2015/12/18

Dr. Li Yilun reply Urology

Your symptoms are indicative of a urinary tract infection, which may include urethritis, cystitis, or pyelonephritis.
Any infection of the urinary system falls under this category and is typically caused by bacteria.
Generally, antibiotic treatment is required, with a course lasting between 7 to 10 days.
However, since you are a young patient without other underlying conditions, some individuals may show improvement after just 3 to 4 days of treatment.
Therefore, the duration of treatment may depend on the physician's clinical experience and the specific circumstances of the patient.

The physician may also determine the treatment plan based on urine tests or urine culture results.
If your current treatment is showing improvement, a complete course of 1 to 2 weeks is usually recommended, and it can be complemented with routine urinalysis to check if inflammatory white blood cell counts return to normal before discontinuing medication.
The manifestations of sexually transmitted infections can vary depending on the specific bacteria involved.
In young males, genital inflammation may be related to sexual activity, and symptoms such as penile itching and small red rashes on the glans may indicate early changes due to skin inflammation.
Balanitis in young males is often associated with sexual activity, so it is essential to rule out the possibility of sexually transmitted infections.

Clinically, a physical examination and palpation are necessary to determine the potential causes of skin changes.
Other causes may relate to hygiene practices, dermatitis, or allergic skin conditions.
Additionally, there may be a connection to diabetes, but the condition can vary significantly among patients.
It is important to note that a simple description cannot provide a definitive diagnosis.
Therefore, if symptoms do not improve, it is advisable to consult a specialized physician for evaluation and examination upon returning home.
Physicians typically require a thorough medical history, physical examination, and tests to confirm the diagnosis and treatment approach.

Reply Date: 2015/12/18

More Info

When it comes to urinary symptoms, particularly those involving frequent urination, bladder pain, and changes in the appearance of the glans (the head of the penis), it is essential to consider various potential causes, including urinary tract infections (UTIs), sexually transmitted infections (STIs), and other non-infectious conditions.

Based on your description, it seems that you have experienced symptoms consistent with a urinary tract infection. UTIs are common and can cause symptoms such as increased frequency of urination, urgency, discomfort or pain in the bladder area, and sometimes even changes in urine color or odor. The fact that you have seen improvement after taking prescribed medication suggests that the treatment is effective, likely targeting the bacterial infection.

However, the lingering sensation of needing to urinate, even after treatment, can be attributed to several factors. It could be due to residual inflammation in the bladder, which may take some time to resolve even after the infection has been treated. Additionally, the presence of a red area on the glans could indicate a localized irritation or inflammation, which might not necessarily be related to a UTI. It could be due to friction, irritation from hygiene products, or even a mild fungal infection.

Regarding your concerns about sexually transmitted infections, it's important to note that while the absence of sexual activity for two months and two weeks reduces the likelihood of certain STIs, it does not completely rule them out. Some infections can remain dormant or asymptomatic for extended periods. Common STIs that could cause similar symptoms include chlamydia and gonorrhea, but these typically present with additional symptoms such as discharge or more pronounced pain.

To address your concerns effectively, here are some recommendations:
1. Follow-Up with Your Doctor: Since you are still experiencing symptoms, it is crucial to follow up with your healthcare provider. They may recommend further testing, such as a urinalysis or urine culture, to ensure that the infection has been fully resolved and to check for any other underlying issues.

2. Examine the Red Area: The red spot on your glans should be evaluated by a healthcare professional. They may perform a physical examination and consider whether a topical treatment or further investigation is necessary.

3. Hydration and Hygiene: Continue to stay well-hydrated, as this can help flush out any remaining bacteria from your urinary system. Additionally, maintain good hygiene practices to prevent further irritation or infection.

4. Avoid Irritants: If you are using any new soaps, lotions, or other products in the genital area, consider discontinuing them to see if your symptoms improve. Sometimes, irritants can exacerbate symptoms.

5. Consider Sexual Health Testing: If you have concerns about STIs, even with the absence of recent sexual activity, discussing testing options with your healthcare provider can provide peace of mind.

In summary, while your symptoms are consistent with a urinary tract infection, the persistence of certain symptoms warrants further evaluation. A thorough examination and possibly additional tests will help clarify the situation and guide appropriate treatment. Always prioritize open communication with your healthcare provider to address any ongoing concerns effectively.

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