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Urethra Sore
I'm 40, healthy active male; married and monogomous. Ten years ago my wife had genital herpes outbreak; never had one myself. I'm active in walking a few days per week and general exercise. A month ago, noticed opening of my penis was getting red and irritated; never any discharge or pain during urination. Wife and I have sex usually once per week; oral and vaginal. Three weeks ago just after sex it was very inflamed and swollen around urethra. Thought this might be my outbreak, because it can stay dormant for years. Went to urologist who examined, took urine speciman (found nothing) and said to "leave it alone" and prescribed anti fungal cream 3X/day. Applying has made no impact; only getting worse. Said if it doesn't get better in three weeks to come back for full STD panel. I was shocked and because it's not getting any better, actually worse, I had full panel (all neg) myself. Can't believe wife gave me anything, but this is strange and really worrying me.
Three weeks now; leaving it alone, no sex, no masturbation, keeping area clean, applying cream as directed.
The soreness and swelling has grown from just the lips to about the size of a thumbnail around urethra. I'm having a hard time urinating at night, really have to push to get it out. Swelling area sometimes stings like hell now, with no visible ulcering but it's a darker color more, red than grey. Still no discharge in any manner. It's been three weeks; cream is not making any impact and its' getting slightly worse. Two days ago my tongue swelled up with two, 2 inch ulcers out of the blue; may not have any connection other than stress. They are subsiding now, but between the two of these areas, I'm getting nervous. What the hell is this and can you recommend how to proceed?
Three weeks now; leaving it alone, no sex, no masturbation, keeping area clean, applying cream as directed.
The soreness and swelling has grown from just the lips to about the size of a thumbnail around urethra. I'm having a hard time urinating at night, really have to push to get it out. Swelling area sometimes stings like hell now, with no visible ulcering but it's a darker color more, red than grey. Still no discharge in any manner. It's been three weeks; cream is not making any impact and its' getting slightly worse. Two days ago my tongue swelled up with two, 2 inch ulcers out of the blue; may not have any connection other than stress. They are subsiding now, but between the two of these areas, I'm getting nervous. What the hell is this and can you recommend how to proceed?
MEDICAL PROFESSIONAL
Maybe your repeated self exams have traumatized your urethral meatus. I did not think of that and it is a good point. In my practice I have not noticed a predilection for BXO in uncircumcised men.
As far as treatment, my original recommendation is unchanged.
S.A.Liroff, M.D.
As far as treatment, my original recommendation is unchanged.
S.A.Liroff, M.D.
Visited GP yesterday as nothing has changed. Upon examination he doesn't think he sees anything that could be STD, but puzzled anti fungal cream isn't making any impact. By the way, I'm circumsized and most of my research indicates this BXO occurs in those who have not had this procedure. I'm also exceptionally clean and shower daily, but very active in walking, riding, swimming etc. After I started noticing the initial irritation, I examined myself a lot; maybe too much. As this puzzled me, I frequently spread my urethra to look down into it and it snowballed from there. Could this be the cause? I'm really struggling to understand how this happened. My GP was slammed yesterday and I had to leave for a meeting, so he only was with me for less than 5 minutes and didn't really answer many of my concerns. I'm looking for some guidance here.
My GP prescribed 150mg tablet Fluconazole and also 14 day Cipro. He told me to discontinue using cream and see if this works. If this Fluconazone doesn't work, would the likely cause be from bacteria? The reason I ask is I've read one cause of this is from using antibiotics which throw off natural yeast balance. To someone who is not overly educated on this sort of thing, it seems strange to take both of these two medicines at once, as they react to each other.
Any feedback would be appreciated.
My GP prescribed 150mg tablet Fluconazole and also 14 day Cipro. He told me to discontinue using cream and see if this works. If this Fluconazone doesn't work, would the likely cause be from bacteria? The reason I ask is I've read one cause of this is from using antibiotics which throw off natural yeast balance. To someone who is not overly educated on this sort of thing, it seems strange to take both of these two medicines at once, as they react to each other.
Any feedback would be appreciated.
MEDICAL PROFESSIONAL
I would suggest that you see a dermatologist. You may have an active case of Balanitis Xerotica Obliterans (also called lichen sclerosis et atrophicus). Note that active BXO appears differently than the more typical chronic situation with pale color and narrowing of the urethral opening. The usual treatment is high potency steroid cream/ointment. Certainly mention the mouth ulcers that you developed to this physician.
If the dermatologist does not have the answer, then I think that you should see a urologist.
S.A.Liroff, M.D.
If the dermatologist does not have the answer, then I think that you should see a urologist.
S.A.Liroff, M.D.
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