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Urology (Expert Forum)
Genital Tubercuosis?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Genital Tubercuosis?
by tommy1974, May 16, 2007 12:00AM
Hello Dr.
I had unprotected sex on several occasions with an American woman in Afghanistan who turned out to be a complete fraud. Big mistake. Had sex 5 times. The last occasion(28 Dec), she was very dry and there was a serious amount of friction. I heard a pop but felt no pain or did not notice any discoloration. Roughly 10 days later, I noticed three small painless dots above my foreskin and a small painless red strip under my foreskin. Also diagnosed with chlamydia/Treated. About a week later, a painless ulcer appeared and then healed within 3-5 days, leaving a small scar. The glans has gotten smaller and became discolored; began to hang from the shaft. Tested for everthing. All negative.
It's been almost 5 months since the last exposure. Currently taking Doxy for 21 days for possible LGV(a friend is an infectious disease doctor). Occasional pain in left testical. Scrotum is red from excess veins and have also developed varicose veins on shaft. From foreskin up is substantially smaller than the shaft. It also has a pinkish color from the foreskin to the glans. Stomach problems developed about three weeks after exposure. Diagnosed from endoscopy/colonscopy with Gastritis and erythematous mucosa in the antrum three days ago. Also developed significant perianal rash(started 28 Feb) which is currently being treated with prescribed cream. Awaiting results of biopsy and stool sample.
Currently experiencing irritation in urethra, my penis seems to have decreased in size by about 20%, excessive amount of varicose veins(obvious physical trauma) and my scrotum feels like it has constant irritation. At times, my penis and skin of my scrotum feel numb. Been to great doctors(mayo clinic) and they say it is all in my head. Trust me Dr., there is something wrong-I know my body. After doing countless hours of research and spending thousands of dollars on medical expenses, I am pretty much at the end of my rope. Do you have any idea as to what this could be? Could this possibly be Genital tuberculosis? If so, would a regular PPD show positive if it was present in my genitals? Will the foreskin glans grow back to the original size? The woman was a compulsive liar and is denying everything so asking her is useless.(She lied about her entire identity and basically ruined my career in Afghanistan). I am confident she had something infectious; I know for a fact she had Chamydia. This is really destroying my life. Please help.
I had unprotected sex on several occasions with an American woman in Afghanistan who turned out to be a complete fraud. Big mistake. Had sex 5 times. The last occasion(28 Dec), she was very dry and there was a serious amount of friction. I heard a pop but felt no pain or did not notice any discoloration. Roughly 10 days later, I noticed three small painless dots above my foreskin and a small painless red strip under my foreskin. Also diagnosed with chlamydia/Treated. About a week later, a painless ulcer appeared and then healed within 3-5 days, leaving a small scar. The glans has gotten smaller and became discolored; began to hang from the shaft. Tested for everthing. All negative.
It's been almost 5 months since the last exposure. Currently taking Doxy for 21 days for possible LGV(a friend is an infectious disease doctor). Occasional pain in left testical. Scrotum is red from excess veins and have also developed varicose veins on shaft. From foreskin up is substantially smaller than the shaft. It also has a pinkish color from the foreskin to the glans. Stomach problems developed about three weeks after exposure. Diagnosed from endoscopy/colonscopy with Gastritis and erythematous mucosa in the antrum three days ago. Also developed significant perianal rash(started 28 Feb) which is currently being treated with prescribed cream. Awaiting results of biopsy and stool sample.
Currently experiencing irritation in urethra, my penis seems to have decreased in size by about 20%, excessive amount of varicose veins(obvious physical trauma) and my scrotum feels like it has constant irritation. At times, my penis and skin of my scrotum feel numb. Been to great doctors(mayo clinic) and they say it is all in my head. Trust me Dr., there is something wrong-I know my body. After doing countless hours of research and spending thousands of dollars on medical expenses, I am pretty much at the end of my rope. Do you have any idea as to what this could be? Could this possibly be Genital tuberculosis? If so, would a regular PPD show positive if it was present in my genitals? Will the foreskin glans grow back to the original size? The woman was a compulsive liar and is denying everything so asking her is useless.(She lied about her entire identity and basically ruined my career in Afghanistan). I am confident she had something infectious; I know for a fact she had Chamydia. This is really destroying my life. Please help.
Doctor's Answer
by Kevin Pho, MD, May 17, 2007 12:00AM
, May 17, 2007 12:00AM
It seems like you have had a comprehensive evaluation, including physicians at the Mayo Clinic. I am assume that significant testing has already been done. Doxycycline is appropriate treatment for Chlamydia. Things like gonorrhea can be treated with the antibiotic ceftriaxone.
I would also evaluate the prostate for infection, since this can cause refractory symptoms. This would include a prostatic massage and any fluid analysis sent for culture and analysis. A transrectal ultrasound can also be done to look for abscess.
If infection has been ruled out, a cystoscopy can be done to look for anatomical abnormalities like a urethral stricture or polyp. A PPD and AFB smears of the sputum should be considered if TB is considered.
These options should be discussed with a urologist. A dermatologist can also be considered to look and possibly biopsy any skin lesions.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
I would also evaluate the prostate for infection, since this can cause refractory symptoms. This would include a prostatic massage and any fluid analysis sent for culture and analysis. A transrectal ultrasound can also be done to look for abscess.
If infection has been ruled out, a cystoscopy can be done to look for anatomical abnormalities like a urethral stricture or polyp. A PPD and AFB smears of the sputum should be considered if TB is considered.
These options should be discussed with a urologist. A dermatologist can also be considered to look and possibly biopsy any skin lesions.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
