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Glans around urethra is red and painful and aching side of penis

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hello. i am a 33 year old man living in the uk.
my problem is causing me great distress and i feel like i cant go on like this much longer.
my glans around the urethra is red and painfull. it is especially painful after sex and masturbation. i also have a strange ache down the left side of my penis and general aches and pains in my groin and perinium. the pain is very bad after sexual activity but does not hurt when i pass water.
these symptoms started a year ago. i have visted my doctor many times and been prescribed numerous antibiotics and creams. none have had any effect. i have been treated for balanitis and prostatus again without success. i have also been tested for STD's, all the results came back negative.
i have been referred to a urolgist and had a cystscopy, an abdominal scan and x-ray. the cystoscopy did reveal that my urethra was very red but my urolgist discharged me.
i have also seen a dermatologist, had a prostate exam and a rectal exam. still no clue.
during the last year i have had times when passing urine was very painfull. on these occasions i have been diagonsed with a urinary tract infection. this has happened 4 times, the last occasion was only a week ago.
i am desperate for this nightmare to end. i am considering circumcision but that is a last resort. Please please help.

Category: Family Physician-GP

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Following is the reply by Dr Banodkar, Consultant Dermatologist

Hello,

Thanks for posting your query. I can understand your concern.

From the history you provided, I can understand your distress. However to understand what is your exact concern, it would be helpful for me to see a picture of the affected area. That will enable me to give you an opinion regarding your concern. You could upload pics as a follow-up query.

Take care

Regards,
Dr Kruti
Dermatologist and STD Specialist


Patient replied :

Hello,

I have attached 3 photos of the redness around my urethra. I do not know if a skin condition can cause the Urinary Tract infections and the aches & pains I have been having in my penis. I am extremely concerned that this is something serious.


Hello,

Thanks for your reply.

From the pictures, you seem to have inflammation which has lead to dermatitis around the urethral opening.

This is secondary to urinary tract infection that you seem to be having.

I would recommend that you visit your doctor and recommend urine examination.

The causative organism can then be cultured and an antibiotic sensitivity test can be performed which will help in treating your infection effectively.

I would advise you to drink lots of fluids and increase your intake of vitamin C.

I can understand your concern, however since all your symptoms are related to the urinary tract infection, that needs to be treated. For the dermatitis around the urethra, you can apply cortisone cream for a couple of days and it will resolve.

Please let me know if you have any queries.

Take care


Patient replied :

i have already had numerous urine tests and already tried all sorts of creams. none have had any effect at all. could this be thrush?


Hello,

Thanks for your reply. I can really understand your concern.

However, this doesn't seem to be thrush.

Thrush wouldn't cause a redness only around the opening.

In the urine tests that were done earlier, was an organism isolated? That will be helpful in the treatment.

Hence I recommended urine culture and antibiotic sensitivity test.

I would again recommend that you get these tests done if they have not been already done.

Please let me know if you have any queries.

Take care


Patient replied :

Hello,

The urine tests have been inconclusive. The pain and redness are always there but on occasion the pain has been severe. so bad that I could not walk. on these occasions I have had urine tests and a UTI has been detected. I have been treated and the severe pain goes away but the redness and slight pain remain. The urine tests I have had between these flare ups have been negative. The pain is always severe after sex or masturbation. Also applying any kind of cream causes the sorness to become more severe.
There is some redness on the rest of my glans not just around the meatus & urethra. The texture of my glans changes on a daily basis. Some days there seems to be a red rash made up of small red dots near the edge of my glans near the forskin.
I have had maybe 10-20 urine tests in the last year and in 4 of them a UTI or bacteria was detected.
The redness of urethra found in the cystoscopy Is concerning me that along with the pains in my scrotum and down the length of my penis make me think this is something more serious and not a skin condition.
If I do not have sex or masturbate the sore pain seems to fade (but still feels irritated and is still red) and is replaced by the aches in my scrotum and in my penis. As I said before I have tried many different types of creams and antibiotics. I have also changed my washing powder, stopped washing in the area with shower gel (I just use water now)and stopped using condoms (my wife is now back on the pill). I have also had a few occasions where ejaculation has caused me pain in my rear end. Infact it has crossed my mind that there may be a infection in my sperm as passing urine does not irritate as much as ejaculation. I have had my prostrate checked and also I have had blood tests to rule out a prostate issue.
Please Help me. Suicide has crossed my mind more then once.


Hello,

Thanks for your reply. I can understand the distress you are going through.

You are right in the fact that your symptoms are not caused by a skin condition.

The description that you have regarding the redness on your glans indicates you do get yeast infection on it but that cannot lead to the pain you describe.

You can take fluconazole tablets for it and also apply clotrimazole cream on it.

The pain that you describe would need further investigations from a urologist. It would be difficult to opine regarding it on an online portal without examining the patient.

I would recommend you to not worry about it till you can meet your urologist, meanwhile treat the redness on the glans and to abstain from sex or masturbation till you meet the urologist.

Hope my recommendations are helpful to you.

Take care


Dr.
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