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Urology (Expert Forum)
red sore at opening of urethra. accompanying fungus?
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.
red sore at opening of urethra. accompanying fungus?
by glottis, Apr 20, 2003 12:00AM
On or about March 10, I began urinating in a bizarre manner: no mere split stream, but oblique streams going every which way; later I noticed redness all over my glans and a darker redness isolated largely on the lower side of the glans.
I have been to a dermatologist and 2 urologists. All docs concur there is no or probably is no malignancy (but obviously I still have some concern); otherwise, they are somewhat puzzled.
The dermatologist thinks a form of psoriasis, both urologists think a fungal [and with topical anti-fungal cream there is some favorable response]. However, there is now or always was and is more noticeable a small red pimple or sore at and maybe just in the opening of the urethra. The one urologist says biopsy {and cytoscope of urethra and bladder}, the other says it is not necessary. Urinary stream also improved with treatment and returned in a few days following topical administration to normal or nearly so. Redness also reduced or eliminated, excepting this lower maroon redness in an elongated trapezoid shape which presents altogether, less, or nearly not at all, changing from day to day. I have always maintained decent hygiene, and lately tried to be real careful. I have been diagnosed with recent onset diabetes treated with diet and exercise.
Occasionally I can smell my urine, which is unusual also. The red sore entity is sometimes noticeable as a pin *****-almost painful-almost itchy, or at least something is.
I am 60 years old. I have chronic and recurring prostititus and right side orchitis [trauma to right side years ago resulting in orchiopexy bilateral and, later, epipidectomy right side, subsequent presentation post-op of reduction in size of right side testicle by half]. psa has gone over the last 6 months from 3.45 to 3.04 to 2.97 this last taken about 1 month ago.
I am Jewish and was circumcised at 30 days, the 3 week delay of the ritual for presentation of infant jaundice.
Among an attempt at some sort of diagnosis [I need detailed information and the urologists don't seem to fully communicate what they think it is or may be], wouldn't a biopsy at that place result in dangerous scar tissue; but would delaying or not having a biopsy result in a dangerous possibility over time?
Thank you for any possible diagnosis you can give. I am continuing to pursue this, but with work schedule it is not so easy to get in to the offices.
Do you have any idea what this may be? Thank you
(Other than those problems mentioned, I am in good health.)
I have been to a dermatologist and 2 urologists. All docs concur there is no or probably is no malignancy (but obviously I still have some concern); otherwise, they are somewhat puzzled.
The dermatologist thinks a form of psoriasis, both urologists think a fungal [and with topical anti-fungal cream there is some favorable response]. However, there is now or always was and is more noticeable a small red pimple or sore at and maybe just in the opening of the urethra. The one urologist says biopsy {and cytoscope of urethra and bladder}, the other says it is not necessary. Urinary stream also improved with treatment and returned in a few days following topical administration to normal or nearly so. Redness also reduced or eliminated, excepting this lower maroon redness in an elongated trapezoid shape which presents altogether, less, or nearly not at all, changing from day to day. I have always maintained decent hygiene, and lately tried to be real careful. I have been diagnosed with recent onset diabetes treated with diet and exercise.
Occasionally I can smell my urine, which is unusual also. The red sore entity is sometimes noticeable as a pin *****-almost painful-almost itchy, or at least something is.
I am 60 years old. I have chronic and recurring prostititus and right side orchitis [trauma to right side years ago resulting in orchiopexy bilateral and, later, epipidectomy right side, subsequent presentation post-op of reduction in size of right side testicle by half]. psa has gone over the last 6 months from 3.45 to 3.04 to 2.97 this last taken about 1 month ago.
I am Jewish and was circumcised at 30 days, the 3 week delay of the ritual for presentation of infant jaundice.
Among an attempt at some sort of diagnosis [I need detailed information and the urologists don't seem to fully communicate what they think it is or may be], wouldn't a biopsy at that place result in dangerous scar tissue; but would delaying or not having a biopsy result in a dangerous possibility over time?
Thank you for any possible diagnosis you can give. I am continuing to pursue this, but with work schedule it is not so easy to get in to the offices.
Do you have any idea what this may be? Thank you
(Other than those problems mentioned, I am in good health.)
Doctor's Answer
by Kevin Pho, MD, Apr 21, 2003 12:00AM
, Apr 21, 2003 12:00AM
Hello - thanks for asking your question.
Without seeing the lesion myself it is impossible to come up with a clear diagnosis. You have been seen by 2 urologists and a dermatologist without a revealing answer. Please note that they have the advantage of actually seeing you.
Possibilites include genital lesions such as herpes, chanchroid or syphillis. Fungal infections are always a possibility. Atypical warts caused by papillomaviruses may also be possible. STDs such as chlamydia or gonorrhea can present this way.
Tests for syphillis, culture of the lesions, darkfield microscopy, microscopic fungal tests, tests for STDs (chlamydia and gonnorhea) and gram stain may be considered.
You note that you can smell your urine. Given your history of prostatitis, you may want to have your urine sampled and cultured before and after prostatic massage. Chronic prostatitis often requires up to 12 weeks of antibiotics.
If the diagnosis is uncertain, I would proceed with a biopsy since this is the most definitive test. A penile biospy should be performed by your urologist - scar tissue should not be a concern, but without seeing the lesion myself, I would ask this question to your urologist.
I would also consider a cystoscopy to evaluate for any masses or anatomical abnormalities that may be causing your symptoms.
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.
Thanks,
Kevin, M.D.
Without seeing the lesion myself it is impossible to come up with a clear diagnosis. You have been seen by 2 urologists and a dermatologist without a revealing answer. Please note that they have the advantage of actually seeing you.
Possibilites include genital lesions such as herpes, chanchroid or syphillis. Fungal infections are always a possibility. Atypical warts caused by papillomaviruses may also be possible. STDs such as chlamydia or gonorrhea can present this way.
Tests for syphillis, culture of the lesions, darkfield microscopy, microscopic fungal tests, tests for STDs (chlamydia and gonnorhea) and gram stain may be considered.
You note that you can smell your urine. Given your history of prostatitis, you may want to have your urine sampled and cultured before and after prostatic massage. Chronic prostatitis often requires up to 12 weeks of antibiotics.
If the diagnosis is uncertain, I would proceed with a biopsy since this is the most definitive test. A penile biospy should be performed by your urologist - scar tissue should not be a concern, but without seeing the lesion myself, I would ask this question to your urologist.
I would also consider a cystoscopy to evaluate for any masses or anatomical abnormalities that may be causing your symptoms.
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.
Thanks,
Kevin, M.D.
Member Comments (1)
by glottis, Apr 21, 2003 12:00AM
To: Misc. (Urology)
0
by healthymi, Jul 30, 2008 07:06PM
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by healthymi, Jul 30, 2008 07:10PM
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