Balanitis? Or what!?

[jacob911]

For the past 2 months I have been struggling with an ongoing irritation of the penis/glans/foreskin.

I am 26/uncircumcised, with phimosis (can retract, but not easily).

It started off with mild irritation/soreness... nothing too crazy... so I waited... finally, after noticing it getting worse (redness/itchiness/soreness) I went to the GP who prescribed Diflucan.  This seemed to help quite a bit... However, about 1-2 weeks later, I started getting discharge (smelly and yellowish liquid) from under the foreskin.  The soreness also persisted.  I was not able to retract as well, so was unable to see "what was going on" under there.  I finally went back to the doctor 3 weeks later, as it had not cleared up.  He prescribed an antibiotic which I began to take and within a day the discharge ceased and a lot of the redness went down (and I can now retract again).

It has been one week since the antibiotics, and now upon retraction there is a red patch on the glans (oval in shape - well defined border - does not appear raised) and a few smaller red patches on the inner foreskin (noticeable on retraction).  This has probably been there the entire time but was unable to see due to retraction issues.

My question is... What could this be?  Is this remnants from a bad bacterial infection?  Will this probably clear up slowly now that the infection is gone?  Or could this be something else (ie. zoon's balanitis)?  

I am getting so frustrated and just want everything to return to normal!
Please help!

[jacob911]

Thank you Dr. Kaur for your response...
I have taken a course of antibiotics, which eliminated the discharge and seemed to allow the foreskin to retract again.  All that remains now is the prominent red plaque on the glans and additional red/shiny areas on the inner foreskin mucosal dermis (if this makes sense).  They are red-deep red in colour, and are sore to touch... but are not getting better, nor are they getting any worse.

Is this still bacterial balanitis?  Or could this be fungal?  Or some other type of infection/reaction?  

Thanks again

[Bhupinder Kaur, MD]

Hello,
From the symptoms it sounds like balanitis. It is an inflammation of the glans penis. In your case, it can be due to growth of infecting organisms like fungi which aggravate it and thus causing difficulty in retraction and pain while erection. 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.
Hope it helps.Take care and regards.