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What Is The Cause And Treatment For Ballanoposthatitis?

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Posted on Thu, 4 Sep 2014
Question: I have an inflammation of the prepuice, due to some infection. I've gone through a 5 day course of amoxicillin, about 7 days of augmentin, and for the last month or so I've been on doxycycline. About one tablet of doxy-1 keeps the inflammation manageable, but still there. Not taking it increases the inflammation. Is there any approach that can be taken to correct this without circumcision?I should perhaps add a little additional history :

The first symptoms started with a stye in the eye, for which the amoxicillin course was prescribed. The white clumps of material of the head of the penis showed up about 4 days into that course. Inflammation and phimosis quickly followed. The augmentin course was also a 5 day course. The inflammation almost entirely cleared up about 4 days into the course, but was back on the 5th day, dud to which the course was extended for two more days. Doxy-1 produced a similar response, about 3-4 days of 2 per day reduced inflammation significantly, but never completely. Increasing dose to once every 10 hours or so improved the situation, almost clearing up inflammation briefly. Not wanting to continue high-dose antibiotics for such a long time, I've been taking 1 capsule of doxy-1 a day for the last couple of weeks. The inflammation isn't causing any problems during urination. Some mild discomfort in the form of a slight itch, ocassionally, and pain in the foreskin following erections is there.
doctor
Answered by Dr. Dr. P. T. Patil (1 hour later)
Brief Answer:
Symptoms due to Infection of Foreskin.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have infection of the Foreskin and Glans penis (Ballanoposthatitis)

You have been taking antibiotics since almost three weeks and still you have no complete relief from symptoms and have pain while retracting foreskin following erection .This is mainly due to Phimosis that you have developed due to infection .

The white jelly like discharge that you have is what is called as smegma which is excessive thick mucus secreted by mucosal glands located in glans penis .

Please consult qualified Urologist for evaluation and to confirm the diagnosis..

You may need to get circumcised .

This is a simple surgery done under local anaesthesia as a out patient procedure and offers permanent cure and helps to have enjoyable sex for rest of the life.

Ensure to wash your genitals with warm water twice daily.

Hope I have answered your query ,please feel free to ask if you have more questions ,
I shall be happy to help you
Thanks and Regards.
Dr.Patil.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (7 minutes later)
The infection itself is still present. Circumcision will remove the infection, sure, but an infection in the liver isn't treated by removing the liver. Is is possible to first eliminate the infection, to the point where it can be confirmed as removed by a white cell count? As a lay person, the use of topical antibiotics and/or stronger antibiotics, possibly guided by some sort of susceptibility study of cultures of the infection seems like the more natural first steps to these solutions. Are such things possible in the XXXXXXX medical environment? Where could one expect to get healthcare of that quality.

If the scarring then proves permanent, circumcision may be necessary, I concede, but I would like to be absolutely sure that the phimosis is caused by scarring and not by a still present infection.

Also, are there other, less destructive options instead of circumcision, such as partial removal / surgical alteration of the effected region of the foreskin?
doctor
Answered by Dr. Dr. P. T. Patil (18 minutes later)
Brief Answer:
Scarring is the end result of infection.

Detailed Answer:
Hello
Thanks for follow up.
The scarring of the foreskin is the end result of healing process and can not be cured by taking medicines further .

The other option to circumcision is dorsal slit where foreskin is incised dorsally so that it can be retracted freely over glans penis which is mandatory to clean the glans and maintain personal hygiene by removing smegma every day while taking bath and to retract the foreskin during sex.However this surgery(Dorsal slit) has poor cosmetic results and is not accepted by most of the patients as it changes look of the penis .

As regards liver infection that you have mentioned the raised SGPT level can be due to metabolic disorder and not necessarily due to infection It can be corrected by appropriate medicines .Please consult qualified General Physician for guidance .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (10 minutes later)
I'm sorry. Thank you for your quick reply, but you misunderstood my question. The infection still persists. There continues to be smegma build-up, the inflammation still responds to the antibiotic (by increasing when antibiotic is not taken), topical corticosteroids reduce the level of inflammation without fail, meaning that there still is inflammation likely due to infection, and not just scarring. I would like to get rid of the infection _BEFORE_ going in for surgery to correct any scarring that may have occurred. I'm willing to try stronger antibiotics, topical antibiotics, or have the infection tested in whatever way possible to determine what the infection is an what the best way to fight it is. To that end, I'd like to be able to do it in a reasonably guided manner instead of randomly selecting antibiotics without knowing about them.
1) Is there anything I can say at a hospital or a path centre to have the infection tested for organism and/or antibiotic susceptibility of the organism
2) Is there an antibiotic stronger than Doxy-1 available that can be tried or is indicated in such infections
3) Is it possible that the infection is, in fact, caused by candida and not by bacteria? Note that the symptoms of the foreskin started 4 days into a course of amoxicillin for an infection in the eye, and a day after the eye itself cleared up fully. Would a course of fluconazole make sense in such a situation?
doctor
Answered by Dr. Dr. P. T. Patil (8 hours later)
Brief Answer:
Get swab &culture test of discharge done.

Detailed Answer:
Hello
Thanks for follow up.
Please get culture and sensitivity and swab test of a discharge from foreskin done to find out the organisms causing this infection and antibiotics to which they are sensitive to ,so that infection can be controlled by taking appropriate antibiotic as per culture report.There is no term like strong or weak antibiotics .

Swab test will help to detect or rule out fungal infection.

Once the infection subsides you may decide regarding Circumcision if required.

Thanks and Regards.
Dr.Patil.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10583 Questions

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What Is The Cause And Treatment For Ballanoposthatitis?

Brief Answer: Symptoms due to Infection of Foreskin. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have infection of the Foreskin and Glans penis (Ballanoposthatitis) You have been taking antibiotics since almost three weeks and still you have no complete relief from symptoms and have pain while retracting foreskin following erection .This is mainly due to Phimosis that you have developed due to infection . The white jelly like discharge that you have is what is called as smegma which is excessive thick mucus secreted by mucosal glands located in glans penis . Please consult qualified Urologist for evaluation and to confirm the diagnosis.. You may need to get circumcised . This is a simple surgery done under local anaesthesia as a out patient procedure and offers permanent cure and helps to have enjoyable sex for rest of the life. Ensure to wash your genitals with warm water twice daily. Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you Thanks and Regards. Dr.Patil.