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Red rash on penis, itchy, sore testicles, diminished urine flow, abdominal discomfort, discoloration of glans. Worried about balanitis

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Practicing since : 1995
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I think I have chronic ballanitis

Age: 42
Gender: Male
Status: Married

Here are my symptoms and problems:

1. It started as a red rash long long back under the foreskin and the rash kept on coming and going on using fucidin ointment. Later the rash spread to whole of glans.

2. I feel itch (not very often) under foreskin of penis. But when it does on itching foreskin gets remarkebly inflamed (I sometimes have to take cetrezine tab) and the itch and inflamation subsides.

3. My testicles feels tender at times and some times slightly sore (slight discomfort)

4. My urine flow appears diminshed (mainly during erection, maybe due to swelling in glans or stricture). Even ejaculation does not happen in proper stream and feels restricted

5. Since past 1 month slight uneasyness in lower abdomen and feeling of swelling and tightness. I wont call it pain but lower abdomen feels a kind of stress mainly while sitting and working or while sitting and bedning forward. Lower abdominal discomfort reduces on lying down.

6. There seems to be slight discolouration of glans too



1. I do not get any remarkable discharge of anykind though from under the foreskin, but at times the under foreskin area appears moist on retracting the foreskin
2. Foreskin is easily retractable without pain or discomfort
3. I got my fast/pp sugar done it was normal
4. I got my urine culture done it was sterile and R/M done it was normal
5. I do not have any kind of ulceration on glans
Posted Mon, 21 May 2012 in Penis Problems
 
 
Answered by Dr. Vineet Malhotra 19 hours later
Hello,

Thanks for your query,

Your detailed history and medical reports do seem to suggest that you may have some balanitis/balanoposhthitis. These indicate an inflammation of the glans/prepuce and is commonly seen in diabetics. Topical steroid and antibiotic creams can be used under guidance of your doctor to treat this problem.

As you also report of urinary symptoms and lower abdominal discomfort, you are advised to undergo an ultrasound examination of the Abdomen and Uroflowmetry test. These symptoms could be indicative of some urinary outflow obstruction and these tests should help us with the diagnosis. Urinary outflow obstruction is common in men above 40 years of age. This can be managed separately by medical drugs.

I hope to hear from you soon.

Wish you good health

Dr Vineet Malhotra
Above answer was peer-reviewed by
 
Follow-up: Red rash on penis, itchy, sore testicles, diminished urine flow, abdominal discomfort, discoloration of glans. Worried about balanitis 35 minutes later
Dear Dr. Malhotra,

Kindly reply all my questions below, I shall be very thankful for same:

Apart from ultrasound examination of lower abdomen what other tests are required.
How will the organism causing ballanitis (type and strain of fungi or bacteria) will be detected and determined? What tests are required to determine the ballanitis causing pathogen or organism?

Further can you recommend some local antifungal topical ointment which I may use on glans or foreskin which could be helpful in my case.

Also can you recommend some anti inflamatory for inflamation of glans? (This might also help in urine flow as the inflamation would subside the urine flow shall obviously improve a little)

Do you suggest I should start some broad spectrum antibiotic?

At times I really get worried that why is this happening, I have never had sex with anyone except my partner, also I am not diabetic. I always get this scary thought of its not cancer or something.

Do I need to get some blood test done for veneral diseases also?

DO YOU THINK I NEED ANY KIND OF SURGERY? WILL I RECOVER FROM THIS PROBLEM? HOW SERIOUS DO YOU THINK MY CASE IS?

Please advice
 
 
Answered by Dr. Vineet Malhotra 39 minutes later
Hello,
Thanks for writing back.
1.     I would suggest you to undergo an ultrasound examination of the whole abdomen, a uroflowmetry test, urine analysis for fungus, Serum IgG and IgM for fungal infections are the most common cause of these symptoms, using an ointment such as ZOLE-F may help.
4.     I would suggest you to consult your local urologist for specific medication since an alpha blocker would be more useful rather than an anti-inflammatory agent.
5.     Antibiotics are prescription drugs and an examination is necessary before they can be prescribed. I would suggest that you consult your urologist so that he can prescribe one after examining you.
6.     I don’t think that this is an alarming or serious condition.
7.     I will need to know these reports to advise further treatment.

I hope I have answered your query. I will be happy to answer any follow-up queries

Wishing you good health
Dr Vineet Malhotra
Above answer was peer-reviewed by
 
Follow-up: Red rash on penis, itchy, sore testicles, diminished urine flow, abdominal discomfort, discoloration of glans. Worried about balanitis 1 hour later
Thank you Dr. Malhotra,

I shall get the abdomen ultrasound and uroflowmetry test, urine analysis for fungus, Serum IgG and IgM for recommended by you and shall start antibiotics as per outcome of above tests if required.

Is testicle tenderness and slight sourness on feeling with fingers is due to ballanitis?
Will this alpha blocker subside this testicle sourness too?

I will be thankful if you could prescribe/suggest any alpha blocker with dosage for relief from inflamation.

Regards

 
 
Answered by Dr. Vineet Malhotra 8 hours later
Hello,
Thanks again

The sensation in the testicles maybe related to the urinary symptoms and not to the balanitis.

Medication like Alfuzocin is a good alpha blocker drug which will help you with the inflammation.Do consult your treating doctor for the right dosage .

I hope i have answered your query.
If you are satisfied with the answer please close the discussion.

Wishing you good health
Dr Vineet Malhotra
Above answer was peer-reviewed by
 
Follow-up: Red rash on penis, itchy, sore testicles, diminished urine flow, abdominal discomfort, discoloration of glans. Worried about balanitis 7 hours later
Dear Dr. Malhotra,

Just last queries before I close this discussion please.

QUERY1:
I shall be giving my blood sample today for getting the test Serum IgG and IgM for herpes simplex virus 1 and 2 done.

Besides Serum IgG & IgM do I need to get any other blood tests done like gonorrhea or any other likewise veneral disease? If yes I would get that done in the same blood sample. So please let me know if any other blood tests are required?

Will Serum IgG & IgM tests be sufficient to determine ballanitis causing organism? What if the causitive organism is any anaerobic bacteria? From which test will that be determined?

QUERY 2:
Regarding urine examination do I tell the pathology to get urine test for fungus done or does this urine fungus test has some psecific name?

QUERY 3:
Please let me know if any other blood or urine examinations besides mentioned above are required to get a better picture and I will get it done all together. Else I will have to give blood and urine samples again.

Sorry to bother you but this last reply from your would be quite satisfying.

Regards
 
 
Answered by Dr. Vineet Malhotra 1 hour later
Hello,
Thanks for writing back.
1. The IgG and IgM tests are for viral antibodies and do not detect bacterial causes. If the causative organism is a bacterium, we would know that from the report of the urine culture.
2. The test which will detect fungal infection in the urine is called “Urine for fungal hyphae”
3. I think we should restrict ourselves to these tests initially. If the reports suggest something, we can proceed with some specific tests later.
I hope I have answered your query.

Wishing you good health
Dr Vineet Malhotra
Above answer was peer-reviewed by
 
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