YANMD - Itchy penis edition
March 14, 2018 5:13 AM Subscribe
The tip around my urethra opening is red, itchy and swollen. It has been for about four months. I'm a married man who has been faithful. My wife has no symptoms and has also been faithful. The docs have done the usual STD swab/urine tests and found nothing.
I'm not circumcised. The opening is noticeably red and swollen, like little lips. I have no discharge whatsoever. No pain while urinating or ejaculating, although my sex drive seems to have dropped significantly (could be psychological). I do still have sex. I was using a condom for about a month while taking treatments, but have since given up on it.
Sites like this suggest there is often discharge with urethritis, which is the best diagnosis I can come up with. I've ruled out soaps and laundry detergent.
My main family doc more or less threw up her hands and said - "Seems OK. Keep putting canesten on it. I wouldn't worry." It is not a yeast infection. I've had that. I've since gone back to get a referral to a urologist, but I've been told it will take months.
I've been given azithromycin (basically what you'd get for Chlamydia), as well as topical antibiotics. Neither worked. There are a pile of online health forums where guys are complaining of the same sorts of symptoms, also not testing positive for STDs.
I'm wondering if this happened to you, and what worked to resolve it. Here's a throwaway email if you'd care not to comment publicly: thufrapach@qwfox.com
I'm not circumcised. The opening is noticeably red and swollen, like little lips. I have no discharge whatsoever. No pain while urinating or ejaculating, although my sex drive seems to have dropped significantly (could be psychological). I do still have sex. I was using a condom for about a month while taking treatments, but have since given up on it.
Sites like this suggest there is often discharge with urethritis, which is the best diagnosis I can come up with. I've ruled out soaps and laundry detergent.
My main family doc more or less threw up her hands and said - "Seems OK. Keep putting canesten on it. I wouldn't worry." It is not a yeast infection. I've had that. I've since gone back to get a referral to a urologist, but I've been told it will take months.
I've been given azithromycin (basically what you'd get for Chlamydia), as well as topical antibiotics. Neither worked. There are a pile of online health forums where guys are complaining of the same sorts of symptoms, also not testing positive for STDs.
I'm wondering if this happened to you, and what worked to resolve it. Here's a throwaway email if you'd care not to comment publicly: thufrapach@qwfox.com
I found out from an allergist that genital skin irritation can be caused by food allergies.
You eat the irritant food (cinnamon, chilli, etc), and then there are enough traces of the irritant food in your urine to cause skin irritation.
The more of the irritant food you eat, the worse it gets, but the only solution is to identify the problem food and strictly avoid it.
posted by Murderbot at 5:59 AM on March 14, 2018 [5 favorites]
You eat the irritant food (cinnamon, chilli, etc), and then there are enough traces of the irritant food in your urine to cause skin irritation.
The more of the irritant food you eat, the worse it gets, but the only solution is to identify the problem food and strictly avoid it.
posted by Murderbot at 5:59 AM on March 14, 2018 [5 favorites]
Seconding the suggestion to see a urologist.
In the realm of genital health for vulvas, it's not terribly uncommon for there to be specialized health challenges that even OB/gyns (who specialize in fertility and pregnancy, hence the "obstetrics" part) aren't familiar with--but that urogynecologists know well. (I've known several women who suffer from lichen sclerosis for varying periods, up to and beyond a decade, before ending up with a urogynecologist.) I would imagine that's true for penises too--specialists just know stuff that internists don't.
posted by Sublimity at 6:18 AM on March 14, 2018 [3 favorites]
In the realm of genital health for vulvas, it's not terribly uncommon for there to be specialized health challenges that even OB/gyns (who specialize in fertility and pregnancy, hence the "obstetrics" part) aren't familiar with--but that urogynecologists know well. (I've known several women who suffer from lichen sclerosis for varying periods, up to and beyond a decade, before ending up with a urogynecologist.) I would imagine that's true for penises too--specialists just know stuff that internists don't.
posted by Sublimity at 6:18 AM on March 14, 2018 [3 favorites]
Much the same thing happened to me under the same circumstances, accompanied by increased foreskin fragility leading to an annoying susceptibility to tearing. I self-diagnosed it as nappy rash, classing that as one of the little indignities of getting older and slightly dribbly. Tried topical antifungals: got slight temporary relief at best. Tried topical antibacterials: also slight temporary relief only. So I'd just been putting up with it, because access to specialists is also quite inconvenient where I live.
But quite unrelated to this ongoing nuisance, I recently copped a bout of cellulitis in my leg. This cost me a week in hospital on intravenous flucloxacillin, another week of the same antibiotic at home via PICC line and Baxter infusors, then a switch to two weeks of oral cephalexin to finish it off.
Having learned that cephalexin is excreted unchanged in the urine, I figured I had two weeks where any dribbles would be working for me instead of against, giving me an opportunity to get on top of whatever nasty little surface microecology was causing me grief and let the skin heal enough to stay resistant to further colonization. So I got really really diligent about applying an antifungal cream (clotrimazole 1%) right after pissing, every single time.
And it's worked. I started seeing real improvement five days after beginning with the antifungal, and after two weeks of excreted antibiotic plus applied antifungal and another two weeks of antifungal alone, everything has now cleared up nicely. I'm still diligently using the antifungal and will keep doing so until the tube is all used, which should take a little longer than the two weeks post-relief continuation recommended by the manufacturer.
posted by flabdablet at 6:43 AM on March 14, 2018
But quite unrelated to this ongoing nuisance, I recently copped a bout of cellulitis in my leg. This cost me a week in hospital on intravenous flucloxacillin, another week of the same antibiotic at home via PICC line and Baxter infusors, then a switch to two weeks of oral cephalexin to finish it off.
Having learned that cephalexin is excreted unchanged in the urine, I figured I had two weeks where any dribbles would be working for me instead of against, giving me an opportunity to get on top of whatever nasty little surface microecology was causing me grief and let the skin heal enough to stay resistant to further colonization. So I got really really diligent about applying an antifungal cream (clotrimazole 1%) right after pissing, every single time.
And it's worked. I started seeing real improvement five days after beginning with the antifungal, and after two weeks of excreted antibiotic plus applied antifungal and another two weeks of antifungal alone, everything has now cleared up nicely. I'm still diligently using the antifungal and will keep doing so until the tube is all used, which should take a little longer than the two weeks post-relief continuation recommended by the manufacturer.
posted by flabdablet at 6:43 AM on March 14, 2018
Have you changed any personal care products? Soap, shampoo, laundry detergent, etc...
posted by zibra at 8:38 AM on March 14, 2018
posted by zibra at 8:38 AM on March 14, 2018
Oh, one other thing to consider:
whatever hand wash you use (including whatever you use to wash your hands in public toilets) can be very irritant if it's fragranced.
This is especially an issue if you wash your hands before going to the toilet,
but even if you wash your hands after (but not before), there can be enough traces of fragrance on your hands from the last time you washed your hands to cause skin irritation...
A dermatologist can do a patch test on your back to see if you have a fragrance allergy.
posted by Murderbot at 8:57 AM on March 14, 2018
whatever hand wash you use (including whatever you use to wash your hands in public toilets) can be very irritant if it's fragranced.
This is especially an issue if you wash your hands before going to the toilet,
but even if you wash your hands after (but not before), there can be enough traces of fragrance on your hands from the last time you washed your hands to cause skin irritation...
A dermatologist can do a patch test on your back to see if you have a fragrance allergy.
posted by Murderbot at 8:57 AM on March 14, 2018
It is not a yeast infection. I've had that.
I'm assuming they swabbed/tested to be sure, but it could be a yeast infection, even if it doesn't feel the same as your previous one. Yeast infections are weird like that. So rule it out for sure.
Other possibility, and it's maybe a long shot, but has your wife also had a full STD panel? Trichomonasis is quite common, and most people who have it don't develop obvious symptoms. People can have it for years and never know. It's possible that it wasn't included in your STD panel or a consideration for your provider, since people with penises experience symptoms even more rarely and aren't always tested for it, but the symptoms are consistent with what you're describing. If you were given the full results of your panel, take a look and see if they tested for trich, and perhaps consider asking your wife to get a test for trich to rule out a false negative if you were tested.
It's caused by a parasite, not a bacteria or fungus, so antifungals and most antibiotics won't touch it. Metronidazole or tinidazole can clear it up, though.
posted by halation at 10:19 AM on March 14, 2018 [1 favorite]
I'm assuming they swabbed/tested to be sure, but it could be a yeast infection, even if it doesn't feel the same as your previous one. Yeast infections are weird like that. So rule it out for sure.
Other possibility, and it's maybe a long shot, but has your wife also had a full STD panel? Trichomonasis is quite common, and most people who have it don't develop obvious symptoms. People can have it for years and never know. It's possible that it wasn't included in your STD panel or a consideration for your provider, since people with penises experience symptoms even more rarely and aren't always tested for it, but the symptoms are consistent with what you're describing. If you were given the full results of your panel, take a look and see if they tested for trich, and perhaps consider asking your wife to get a test for trich to rule out a false negative if you were tested.
It's caused by a parasite, not a bacteria or fungus, so antifungals and most antibiotics won't touch it. Metronidazole or tinidazole can clear it up, though.
posted by halation at 10:19 AM on March 14, 2018 [1 favorite]
Instead of waiting for a referral, why not go to Planned Parenthood? They serve people with penises, and I bet you can get an appointment later this week.
posted by tapir-whorf at 10:37 AM on March 14, 2018 [2 favorites]
posted by tapir-whorf at 10:37 AM on March 14, 2018 [2 favorites]
I’m assuming urinalysis included a glucose check, but just in case: if there is any chance of undiagnosed diabetes, sugar in your urine (and yes, the yeast it promotes) can cause itching around the genitals.
posted by armeowda at 8:38 PM on March 14, 2018
posted by armeowda at 8:38 PM on March 14, 2018
Here's a tip (no seriously): every morning when you get out of the shower pull back the foreskin and dry the area with a blow dryer (on cool setting). And dab it dry with toilet paper or a kleenex after you pee. Keeping it dry helps with mysterious fungal/yeast issues.
posted by RandlePatrickMcMurphy at 8:34 AM on March 16, 2018
posted by RandlePatrickMcMurphy at 8:34 AM on March 16, 2018
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posted by cooker girl at 5:43 AM on March 14, 2018 [9 favorites]