recurent yeast

[tictactoe]

Hi doc,

I have been suffering from yeast infections for the last 9 months, about one every 1-2 months (most of them were confirmed by a GP). The anti-fungal cream works, and everything clears up in a few days. My first question is: Is it yeast balanitis for it to recur so often (am not circumcised btw)? If so, how to end it?
Lately (since 2 weeks), I have been experiencing some other symptoms along with the yeast infection: I feel like a stitch in both or either of my scrotums, and a slight burning/stinging around the meatus (it happens after urinating -- mostly after the 1st urine of the morning, but sometimes during the day too). What could that be? My last sexual encounter (with condom) was like 3 and a half months ago, could the new symptoms be related to some infection caught back then?

thanks

[Edward W Hook, MD]

Your results are negative and you have been treated.  You can safely assume that the symptoms that you are expereincing are not due to NGU.  EWH

[tictactoe]

Got my chlamydia and gonorrhea lab results back: both negative (condoms work). However, I still have the symptoms (slight burning, testicle pressure -- yeast was already gone when I went to the clinic though) despite my taking the antibiotics given by the GUM doctor. How long before they take effects, and should they be effective anyways in absence of chlamydia? Do I need further testing to cure that NSU? thanks Doc.

[Edward W Hook, MD]

No there are many potential casues of urine sediment, most of them normal and/or inconsequential.  EWH

[tictactoe]

Doc,

I have one more question: when giving the urine sample (first urine of the day), I notice some whitish sediment settling at the bottom of the bottle. Is that related to a specific infection in my urinary tract?

Thanks

[Edward W Hook, MD]

The question you ask is almost unanswerable.  It is quite possible that a yeast infection could cause both your symptoms and the NSU findings.  At the same time, even with consistent condom use making the chance that you have passed infection on to a partner miniscule, the safest possible approach would be to treat both you and, if you have had unprotected sex, your new sex partner.  Is it necessary?  I don't know.  Is it the most prudent approach in terms of her safely, yes.  Personally, I would explain the situation - you ahve a yeast infection, it may be casuing these finding but the safest thing for both of you is for you both to be treated.  Hopefully she will understand and agree.  EWH  

[tictactoe]

Doc,

being concerned about my other symptoms (slight stinging/burning after peeing,  pressure on my testicle), I went to the GUM clinic. They performed swab tests and collected urine samples. The first swab test was negative, so I did another one without passing urine overnight. That second test confirmed I have so far NSU (NGU). They have to wait until the chlamydia and gonorrhea test results come back to say if it's an STD or not. My questions are: what are the odds it is due to chlamydia, can it be solely related to the yeast infections? I am asking because I have always used condoms (even when receiving oral) -- didn't notice if one of them ever broke or not though. As well, I met someone new lately. If my NSU is a real NSU (no chlam involved), should I still tell it to my new partner?

Thanks

[Edward W Hook, MD]

Recurrent yeast balanitis most likely occurs because of the moist environment under the foreskin.  I suspect you do not have other contributing factors such as diabetes which might modify your risk or you would have mentioned them.  Addressing your problem, because it is an unusual problem for which there are no good studies to help provide answers and short of circumcision, will likely involve some trial and error.  Here are my thoughts:

1.  The cream may clear thngs up but not completely resolve your infection.  Next occurrence, I'd suggest talking with your doctor and trying fluconazole (oral) therapy.   While single dose therapy is usual effective, in your case, I'd treat for several successive days.
2.  I suspect you are already doing this but be extra sure to make sure that the penis under the foreskin is completely clean and dry after bathing.
3.  If these don't work, you may want to try fluconazole prophylaxis (taking a dose whether or not you have an infection) once weekly for several weeks in a row.

I suspect your other problems are also related to the yeast and will resolve if you cna get the balanitis under control.  Hope this helps.  EWH