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Can STD or balanoposthitis be contracted through unprotected sexual intercourse?

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Posted on Wed, 16 Dec 2015
Question: Hi,
I am a male, 33 yrs,unmarried. I am diabetic since 1 year. RBS average 230 mg/dL, on diet control and herbal medications. I had unprotected vaginal sex once on 19 march 2015,with a girl having multiple sex partners. Following this, after 3-4 days,thin milky white,non-smelly discharge started from the tip of my penis. It was associated with intense itching and irritation of both glans and foreskin of penis ( I am uncircumcised). There was no pain, fever or difficulty in voiding urine.
I studied lots of internet articles, and without testing, I started the following medicines, immediately:
1. Cap. Doxycycline 100mg bid for 7 days
2. Tab. Cefixime 400mg stat
3. Tab. Azithromycin 2g single dose
4. Topical Metronidazole gel
Following this, the discharge amount decreased for few days and again reappeared. There was no ulcer in glans or foreskin, but irritation, intense iching, redness was there. Again, I started after 1 month or so:
1. Tab. Levofloxacin 500 mg bid for 7 days
2. Tab. Metronidazole 400 mg bid for 7 days
3. topical steroid+ anti-fungal ointment.
I got partial response from the above treatments. Discharge decreased in amount, inflammation and itching of the glans and foreskin of penis almost subsided, although very scanty amount of discharge appeared ocassionally after few days interval. I repeated 3-4 times,the levofloxacin 500mg tab, 7 day course, since the start of my problems.
The discharge now is non-smelling, a bit thicker, light yellow color,appears ocassionally after many days.No irritation,itching,pain fever or any associated problems now. Only a new problem, narrowing of the opening of the foreskin, since past few months (which now become of a fixed size, as you can see in the photo attached). Although, it has not created problems in urination, but I cannot retract the foreskin over glans like before.
Now, my questions are:
1. Is it probably STD or Balanoposthitis ?
2. What type of infection may be, if any ? is it is bacterial, fungal or viral ?
3. How the hole in the opening of foreskin can be made bigger without non-surgical intervention ?
Worth mentioning here, I didn't have any fever, weight loss, cough, feeling of exhaustion or any similar problem throughout the course of my problems. Also, my female sex partner neither reported me of any vaginal discharge after the sex act. As far as I am concerned, she is totally healthy now.
Please suggest me the best available treatment, in details.... which can be tried even without any testing.
doctor
Answered by Dr. Kakkar S. (1 hour later)
Brief Answer:
Seems like a candidal balanoposthitis

Detailed Answer:
Hello. thank you for writing to us

I have gone through your query abd I have understood your concern.

I think the narrowing of prepucial opening is due to candidal balanoposthitis. Itching and scanty thick discharge is a point in favor of candidal balanoposthitis.

If i was the treating doctor i would suggest you to take a single dose of oral fluconazole tablet. Topically you may use antifungal+steroid combination cream e.g clotrin-b cream twice daily.

Besides, you must screen for all the STDs.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (35 minutes later)
Thanks... and Sorry,I forgot to mention, I took single dose of oral fluconazole-150 mg tablet few months back. Now, as I already mentioned, I got partial relief, which means discharge occur very ocassionally and scanty in amount. Don't know,which antibiotics out of doxycycline, azithromycin, metronidazole, fluconazole etc has worked best. Anyways, as I am not cured fully now, should I continue more oral fluconazole tabs ? If so, please tell me the dosage schedule. And, what tests should i do at the same time ?
doctor
Answered by Dr. Kakkar S. (1 hour later)
Brief Answer:
Single dose of fluconazole; it is imperative to first control bld. sugar

Detailed Answer:
Hi.

Since you are a known diabetic therefore that predisposes you to develop repeated candidal balanoposthitis unless your blood sugar is controlled. Your deranged blood sugar could be one underlying reason for recurrent candidal balanoposthitis Or partial relief with fluconazole, as noticed previously.
I suggest you to first get your blood sugar controlled or this might keep happening again and again Or resolve only partially with treatment or recur soon after treatment is discontinued.
For candidal balanoposthitis the recommendation is to take oral fluconazole 150mg tablet as a SINGLE dose. Topically you may apply clotrin-B or candid-B cream, twice daily for a week. I don't think that you require any of the oral antibiotics which you mentioned although you should get yourself screened for all STDs.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (2 hours later)
Thanks...
As i have already mentioned, the opening of the foreskin of my penis has narrowed down and can't be retracted now(as shown in the photo attached alongwith). With control of blood sugar and application of topical steroid+ antifungal ointment, will it revert back to normal size automatically ? worth mentioning here, narrowed opening of the foreskin hasn't interfered urination. For this any other medication or surgical intervention will be required ?
doctor
Answered by Dr. Kakkar S. (12 hours later)
Brief Answer:
Stricture should resolve with treatment

Detailed Answer:
Hi.

I think the tight opening of foreskin would gradually resolve with treatment for candidal infection.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 3689 Questions

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Can STD or balanoposthitis be contracted through unprotected sexual intercourse?

Brief Answer: Seems like a candidal balanoposthitis Detailed Answer: Hello. thank you for writing to us I have gone through your query abd I have understood your concern. I think the narrowing of prepucial opening is due to candidal balanoposthitis. Itching and scanty thick discharge is a point in favor of candidal balanoposthitis. If i was the treating doctor i would suggest you to take a single dose of oral fluconazole tablet. Topically you may use antifungal+steroid combination cream e.g clotrin-b cream twice daily. Besides, you must screen for all the STDs. Regards