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What Does Painful Urination With Swelling At Penis Entrance Indicate?

Posted on Thu, 6 Mar 2014

Question: I had an outbreak 10 months ago in which I had two hard relatively painless boil like sores on the shaft of my penis and extremely painful urination which caused the entrance to my penis to swell and turn red. I had 2 mg of azithromycin in my house and took 1 mg on back to back days a day after the outbreak. The pain while urinating lasted about a week and the sores went away in about 2 and a half weeks. I have had no recurrence. I had the IgG tests for Herpes I and II last week as well as the blood test for syphilis. All tests came back negative with the herpes results both showing <0.91 and the RPR non reactive. I'm at a loss....what are the probabilities?

Answered by Dr. T Shobha Deepak (5 hours later)

Brief Answer: It's likely to be due to non specific Urethritis Detailed Answer: Hi Greetings of the day Painful urination along with swelling of entrance of penis ( external meatus) suggest the diagnosis of non specific Urinary tract infection of Urethra (Urethritis). These kind of infection are more commonly seen in uncircumcised individual and occurs due to deposition of smegma (white secretion which is normally secreted by glans and foreskin ). It induces chemical irritation and following bacterial infection causes the full blown Urethritis picture. As it responded to Antibiotics and other investigation are negative , there seems to be no cause for concern. Maintain good personal hygeine by thorough washing the shaft and glans with lukewarm water will be beneficial. It's also very important to rule out underlying Diabetes Mellitus by getting fasting blood sugar and post prandial blood sugar levels. Presence of undetected underlying Diabetes could be predisposing factor for such infection. In case you require any further assistance, will be glad to assist you. Take care Best Regards Dr T Shobha Deepak MBBS, MD

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. T Shobha Deepak (12 hours later)

I forgot to mention that I am a circumcised male and I do shower daily. The day of the breakout followed a night of rather vigorous sex. I woke up with painful urination and didn't notice the two sore like growths on my penis until the following day....all symptoms continued to get worse over the first 3 days and I ran a slight fever on the second day. As I said, I started antibiotics on the second day, but my initial thought was that I had acquired herpes. Since the herpes and syphilis tests came back negative is it possible I had some other STD? I've had no other symptoms since that two week period 10 months ago.

Answered by Dr. T Shobha Deepak (24 minutes later)

Brief Answer: STD is unlikely Detailed Answer: Hi Greetings Dear XXXX Having vigorous coitus is also predisposing factor for anterior Urethritis which you had. As you developed the painful urination soon after the sexual intercourse, the cause for the symptom is more likely to be traumatic. STD is unlikely, as majority of STD have incubation period more than 7 days ( incubation period is the time interval between exposure to infective agent and development of clinical lesion or complaint?). Also the test for Herpes and syphilis have turned out negative, I see no cause for worry or concern in your case. Rest be assured and relax. Do get back to me if you need any further assistance, will be glad to assist you. Take care Best Regards Dr T Shobha Deepak

Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar