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Stubborn yeast or something else?
Hello doctors, thank you for this resource. I've been doing a lot of reading around the form and decided to post here because there are similar discussions. Unfortunately I've not found an answer to my concerns. I should point out that I've had a history of prostatitis.
About 4 months ago I first noticed my penis opening was red with occasional urethral irritation. No burning with urination, no dischage. Since then the red opening (sometimes swollen) has persisted and I've had 3-4 cases of balantitis/posthis. This always happens after I masturbate and do not clean right after. I'm uncircumsized; if the semen gets under my foreskin and stays over night I'll have redness the next day. It lasts for a few days and responds very well to loprox.
My GP suggested yeast (I recently finished a course of antibiotics) and perscribed loprox cream and 1x150mg fluconazole. The glans/foreskin respond very well to loprox, but the swollen/red meatus and urethral irritation remain. I was later given 3x150mg of flucnoazole and still no relief.
He has tested me negative for Gonn/Chlam (even though I had no concerns there), and I've had a culture and urine swab that showed nothing. I asked if anything in particular was tested for, he said if there was anything there it would have grown in the lab, and you do not test specifically.
I will have to wait some time to see a specialist (urology) so your insight would be greatly appreciated.
Could this be a yeast infection that is difficult to cure, one that is in my urethra?
What else could this be?
Finally, seeing as how my skin responds so well to loprox, would it be of any benefit/danger to try to get the cream into the urethra?
About 4 months ago I first noticed my penis opening was red with occasional urethral irritation. No burning with urination, no dischage. Since then the red opening (sometimes swollen) has persisted and I've had 3-4 cases of balantitis/posthis. This always happens after I masturbate and do not clean right after. I'm uncircumsized; if the semen gets under my foreskin and stays over night I'll have redness the next day. It lasts for a few days and responds very well to loprox.
My GP suggested yeast (I recently finished a course of antibiotics) and perscribed loprox cream and 1x150mg fluconazole. The glans/foreskin respond very well to loprox, but the swollen/red meatus and urethral irritation remain. I was later given 3x150mg of flucnoazole and still no relief.
He has tested me negative for Gonn/Chlam (even though I had no concerns there), and I've had a culture and urine swab that showed nothing. I asked if anything in particular was tested for, he said if there was anything there it would have grown in the lab, and you do not test specifically.
I will have to wait some time to see a specialist (urology) so your insight would be greatly appreciated.
Could this be a yeast infection that is difficult to cure, one that is in my urethra?
What else could this be?
Finally, seeing as how my skin responds so well to loprox, would it be of any benefit/danger to try to get the cream into the urethra?
MEDICAL PROFESSIONAL
No, I don't agree there is any chance you have any sort of persistent STD. The chance of a missed STD is nil. Probably your urologist doesn't really believe it either, but is reaching for an explanation that will satisfy you or at least justify another try at antibiotic treatment. Some patients don't do well with "We just don't know what's going on here, you'll probably have to live with it, but we'll give it one last try with [drug X]". (Some physicians don't do well with it either!)
And yes, I have had patients in whom persistent urethral disccomfort seemed to result from repeated swabbing.
As implied already, I doubt this next round of antibiotic treatment will make any difference in your symptoms, because I am confident no infection is the cause. I am equally confident you have nothing that will ever harm you or a future sex partner. You may just have to live with your symptoms -- but once you understand it doesn't reflect any important health problem, you'll probably find it's not a problem even if minor symptoms persist.
Finally, I'll get a bit philosophical. Not all symptoms mean disease. Just consider that many people live with back pain, unexplained headaches, or the ankle that hurts for years after the sprain has healed. The genitals have a special place in the psyches of some people, and somehow unexpalined symptoms seem more important. But usually they are not. Once you come to understand this at a gut level, my guess is your symptoms will fade or at least you will live with them without concern.
That will end this thread. Best wishes.
And yes, I have had patients in whom persistent urethral disccomfort seemed to result from repeated swabbing.
As implied already, I doubt this next round of antibiotic treatment will make any difference in your symptoms, because I am confident no infection is the cause. I am equally confident you have nothing that will ever harm you or a future sex partner. You may just have to live with your symptoms -- but once you understand it doesn't reflect any important health problem, you'll probably find it's not a problem even if minor symptoms persist.
Finally, I'll get a bit philosophical. Not all symptoms mean disease. Just consider that many people live with back pain, unexplained headaches, or the ankle that hurts for years after the sprain has healed. The genitals have a special place in the psyches of some people, and somehow unexpalined symptoms seem more important. But usually they are not. Once you come to understand this at a gut level, my guess is your symptoms will fade or at least you will live with them without concern.
That will end this thread. Best wishes.
Hello Doctor,
Redness of the meatus continues. My urologist gave me an exam and noted I was tender in my urethra just under the penis head. He said my urethral glands were inflamed there and possibly infected. I was perscribed 1mg zithro and given Olfoxacin for 6 weeks (2x300 daily).
I've been tested several times now for urethral culture, and at least two urine DNA test for STI. He said these tests sometimes miss infections when the infection is isolated, even STI's, and that it's best to treat broad spectrum (paraphrasing here, I cant remember his exact words).
Would you agree with his assessment?
I'm pretty sure I've had 4 cotton swabs and 2 brushes painfully inserted in my urethra in the past 3 months. Possible this could be the cause of the tenderness?
Finally, after taking this medication what are the chances I could still have a urethral infection?
Redness of the meatus continues. My urologist gave me an exam and noted I was tender in my urethra just under the penis head. He said my urethral glands were inflamed there and possibly infected. I was perscribed 1mg zithro and given Olfoxacin for 6 weeks (2x300 daily).
I've been tested several times now for urethral culture, and at least two urine DNA test for STI. He said these tests sometimes miss infections when the infection is isolated, even STI's, and that it's best to treat broad spectrum (paraphrasing here, I cant remember his exact words).
Would you agree with his assessment?
I'm pretty sure I've had 4 cotton swabs and 2 brushes painfully inserted in my urethra in the past 3 months. Possible this could be the cause of the tenderness?
Finally, after taking this medication what are the chances I could still have a urethral infection?
MEDICAL PROFESSIONAL
I doubt a yeast test was done from your urethra, and wouldn't help anyway. Yeasts normally colonize the genital tract and presence in your urethra would not mean it's the cause of your symptoms.
Since masturbation apparently contributes to your symptoms, perhaps sex with your wife would do so as well. It would be safe, i.e. no harm would come, but it might be an issue from the standpoint of comfort and recurrent symptoms. Also, it is conceivable you and your wife are sharing a genital yeast infection, in which case treating her -- or treating both of you with systemic a systemic drug (oral flucoazole) rather than creams -- might help prevent your symptoms. Another issue to discuss with the urologist.
I look forward to hearing more after the urology visit, bit won't have any further advice until then.
Since masturbation apparently contributes to your symptoms, perhaps sex with your wife would do so as well. It would be safe, i.e. no harm would come, but it might be an issue from the standpoint of comfort and recurrent symptoms. Also, it is conceivable you and your wife are sharing a genital yeast infection, in which case treating her -- or treating both of you with systemic a systemic drug (oral flucoazole) rather than creams -- might help prevent your symptoms. Another issue to discuss with the urologist.
I look forward to hearing more after the urology visit, bit won't have any further advice until then.
Thank you Doctor.
I should point out that I termed this ''recurrent balanitis/posthitis" on my own based on red patches of the glans and foreskin. I trust this does not change your assessment.
I have had a urethral swab and urine culture done. All negative. Would this also rule out yeast in the urethra? Should I avoid sex with my wife during a flare up?
These questions will be my last. I will be sure to follow up after my visit with the Urologist.
I should point out that I termed this ''recurrent balanitis/posthitis" on my own based on red patches of the glans and foreskin. I trust this does not change your assessment.
I have had a urethral swab and urine culture done. All negative. Would this also rule out yeast in the urethra? Should I avoid sex with my wife during a flare up?
These questions will be my last. I will be sure to follow up after my visit with the Urologist.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
It seems very clear that your problem is simply recurrent balanitis/posthitis (or balanoposthitis, as sometimes termed) and not any STD. This sort of problem is common in uncircumcised men, and sometimes is associated with urethral irritation. Some cases are due to yeast, but others are bacterial, or "nonspecific". That yours responds to ciclopirox (Loprox) favors yeast as the cause, but not necessarily. Perhaps any moisturizing cream plus local hygiene -- foreskin retraction and washing -- would be equally effective.
To be certain there isn't a separate problem causing the apparent irritation/inflammation of your meatus (urethral opening), talk with your doctor about a urine or urethral swab test for gonorrhea and chlamydia, if not done before now. But I expect these would be negative.
As implied above, daily or twice daily foreskin retraction and washing with soap and water may bring this under permanent control. If not, and if the problem continues and is especially bothersome, or if some episodes are severe, circumcision can be considered.
All theses are issues to talk over with your urologist. Consider printing out this thread as a framework for discussion; I'm betting s/he will agree with most of what I've said. Feel free to return with a follow-up comment and let me know. In the meantime, don't be worried. This doesn't sound at all serious.
Best wishes-- HHH, MD
It seems very clear that your problem is simply recurrent balanitis/posthitis (or balanoposthitis, as sometimes termed) and not any STD. This sort of problem is common in uncircumcised men, and sometimes is associated with urethral irritation. Some cases are due to yeast, but others are bacterial, or "nonspecific". That yours responds to ciclopirox (Loprox) favors yeast as the cause, but not necessarily. Perhaps any moisturizing cream plus local hygiene -- foreskin retraction and washing -- would be equally effective.
To be certain there isn't a separate problem causing the apparent irritation/inflammation of your meatus (urethral opening), talk with your doctor about a urine or urethral swab test for gonorrhea and chlamydia, if not done before now. But I expect these would be negative.
As implied above, daily or twice daily foreskin retraction and washing with soap and water may bring this under permanent control. If not, and if the problem continues and is especially bothersome, or if some episodes are severe, circumcision can be considered.
All theses are issues to talk over with your urologist. Consider printing out this thread as a framework for discussion; I'm betting s/he will agree with most of what I've said. Feel free to return with a follow-up comment and let me know. In the meantime, don't be worried. This doesn't sound at all serious.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
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