Balanitis or Yeast or something else, Im stumped

[irritated2]

I am a 45 year old male, married for over 18 years.  In the last 5 years I have had recurring bouts of what I originally thought was a yeast infection.  I am not circumcised, I do not engage in any risky sexual behaviors.  They start as small irregular white ulcer like spots on the glans, and there is a definite offensive odor.  They are not blisters,, they are shallow, kind of recessed.  Very painful, seems to fully develop in a few days from beginning.  Diflucan, clotrimazole, Nystatin, nothing seems to help on the anti-fungals.  I recently started taking Acyclovir on my Drs. recomendation, and that does not help either.  Herpes culture was negative every time.  Very frustrating and depressing when it occurs.  I have included a photo, as I cannot seem to find any pics anywhere that resemble my problem. Please be advised it is graphic.  Thank you for any help.

[salutary]

From the picture, it looks like it could be Lychen Sclerosus. This is a type of chronic inflammation which typically presents this type of white lesion. It happens in women as well. Many urologists recommend circumcision because this is associated to cancers which develop many years after the initial presentation of the disease. However, the standard treatment is through long term (3 months) application of a potent corticosteroid called Clobetasol Propionate. This is a much stronger medication than an over the counter hydrocortisone cream.

There is a doctor in Britain who has a theory that this is caused by exposure to urine. It seems pretty believable. You should keep the area dry.

[rmprdl1964]

If it is balanitis than the a steroid cream does work and the balanitis seemed to heal faster than the yeast infections.

I urge you to ask your doctor about a glucose tolerance test for diabetes. It very well could be the cause of the infections. You are also in the age where this would be most likely to present it self. In the case of possible diabetes you would want to get it under control as there could be far greater problems.

Let me know  how you made out?

All the best.

Ron

[Dr J Singh]

Hello,
From the symptoms and picture it looks like balanitis. It is an inflammation of the glans penis. Oral course of antibiotics is needed. In addition, please don’t use any cosmetics on the penis, instead use some topical antimicrobials like Bacitracin or Lotrimin. Also corticosteroids and topical immunosuppressants can be used but they are available under prescription. Also retract the foreskin daily and soak in warm water to clean penis and foreskin. In case the symptoms persist then please consult a urologist/dermatologist for evaluation and antimicrobials and steroids prescription.
I hope it helps. Take care and regards.

[irritated2]

Thanks, I appreciate the info.  If Balanitis could talk it would use the line out of one of my favorite movies 300 when the queen was about to be abused, "This will not be over with quickly and you will not enjoy it"  I just don't get the Drs insistence on circumcision, I didnt have this problem for the first 40 years of my life, but now I have it the last 5, seems like they would want to find the underlying cause.  It's like telling someone with a chronic runny nose to have their nose removed.
It is very frustrating, and very painful in full blown mode, becomes mildly depressing, and the amount of time it takes to shower, retract, dry, cream, find loose fitting clothes, keep towels seperate, endless laundry, etc.... Way too much focus on it.
I would think there were blood tests to rule out candida issues, or nutritional deficiencies, or antibody blah blah blah.  Let me know if anything you have tried seems to work better than anything else.  I feel for you as you have much more challenging issues than I.  Thanks again.  

[rmprdl1964]

Hi,

I'm not sure if you have a yeast infection or if this is balinitis.

I prety much have experienced the same thing that you have. I'm also 45 and have been married for 20 years and also uncircumcised.

My wife used to get yeast infections too and we seemed to be passing it back and forth. I used to get this on my own due to the use of long term antibiotics to treat kidney infections. Most of the time I was able to treat it with Monistet and Canesten. At times if would return within a months time. A few months back I was diagnosed with balanitis after having had a catheter in for over a year. I thought that I had practised good hygiene, by showering or bathing at least every second day. Most often every day. My doctor felt that this was caused by the catheter. I was given a steroid cream to treat it.

Due to having a neurological condition I seem to be more prone to it.

Have you been checked for diabetes as this can also cause reocurrent infetions? Try to stay away from refined sugars as yeast thrives on sugar.

I sincerely hope that you will be able to get it under control. When I had the balanitis my doctor brought up the circumcision option. I told her that I would not go for that since it was something that can be treated. I have no scarring from the yeast or balanitis.

All the best.

Ron