Chronic pain on head of penis, brush/light touch.

[PMTX]

I have been experiencing chronic pain on the head of my penis for more than a year and a half.  I an a circumcised male with hypospadias.  Anything that brushes against the area feels like sandpaper.  This includes underwear (any type including 100% cotton), the touch of my hand, soft sheets, anything.  I do not feel pain from squeezing/pressing on the area.  I am in constant pain as I walk around during normal routine.  Running, and therefore any cardiovascular exercise is completely out of the question.  This all began after I had a bacterial (e coli) infection.  Very painful.  I was treated with Cipro and the e coli was eliminated.  I still had feelings of pain/urgency in urination after the e coli was treated and I have had blood in my urine consistently in urine tests as recently as 3 months ago (although it is a trace amount).  Soon after this I began to feel the pain symptoms originally near my urethral opening and on the head of my penis, now exclusively on the head.  I have tried the following, nothing has helped:

1) Bacitraicine ointment
2) zine, diaper creams, various antibacterial ointments
3) hydrocortisone (2.5%) prescribed
4) Nystatin (powder/cream) prescribed
5) fluconazole (14 days of pills prescribed)
6) home remedies for fungal/yeast including rubbing alcohol, tea tree oil, raw cider vinegar, coconut oil
7) vitamin e
8) shea butter (raw)
9) warm baths
10) warm baths with salt
11) cool showers only, minimal cleansing of the area

In short: I cannot imagine that the source of my pain is bacterial or fungal.

The area in question seems to me sensitive to heat/warmth.  The skin looks blotchy or red at times and this seems to correlate to heat rather than pain.  I have discontinued all cardiovascular exercise due to rubbing and pain.  I was also doing some weight training and was in decent shape for a while, but that has also ceased do to an impingement in my right shoulder.  I have recently gained weight due to this (as much as 25lbs) as well as medicating with food and alcohol.  My sex life (married, monogamous) has been destroyed by the pain/sensitivity as well.

I have seen a urologist for this issue.  He did a scope and found no issues other than some scar tissue in my urethra which he (smoothed out).  He also took a biopsy of the area which came back negative for everything including inflammation of the tissue in the sample.

I have seen a dermatologist who prescribed the hydrocortisone.  She believes this may be allergies (I am dubious as I am allergic to nothing) and I have been waiting 2+ months for the consultation for a patch test.

I have recently attempted to numb the area with lidocaine and a product called "Dr. Numb."  When applied, the area is numb and tolerable and the color of the skin is quite pale.  Unfortunately, when the feeling returns, the area is excruciating and the color becomes quite red.  I will not try this again.

I am at my wits end.  I cannot concentrate and I am very depressed.  I am wondering if the problem may be neurological or if there is some sort of nerve damage/inflammation that can be explored.  I am also interested in anything that could soothe the pain in the short term as it is taking forever to get appointments with various specialist.  Your assistance and expertise would be greatly appreciated.

Thank you,

PM

[charming63]

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[Paderla Anitha, DNB]

Hello and hope you are doing well.

Your symptoms are unlikely to be due to neuropathy. Has diabetes been ruled out? The causes for the sensations on the penile head are dryness, yeast infections, herpes, sexually transmitted diseases, genital warts, allergies and balanitis. They could also be cysts, and infected hair follicles. It could sometimes be be due to pemphigus, aphthous ulcers and cancer. So, a meticulous work up with blood tests and a culture and sensitivity may be needed to diagnose the cause. Please discuss this with your doctor am sure he will provide further assistance.

Hope this helped and do keep us posted.