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What Causes Burning Sensation In Penile Area?

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Posted on Thu, 27 Aug 2015
Question: Dear Sir,

I am a 26 year old male and the problem that I have is
BURNING IN THE COMPLETE PENILE AREA,
FREQUENT URINATION WITH LARGE VOLUMES OF URINE COMING OUT EVERY TIME I URINATE
INCREASED SENSITIVITY TO EVEN A SLIGHTEST TOUCH TO THE PENIS

The burning has the following characteristics. It is

a>.more at the head of the penis (I am an uncircumcised male)
b>.less (but significant) at the shaft of the penis
c>.more in the right testicle
d>.less (but significant)in the left testicle
e>.considerable in the entrance of anus too

Any doctor would doubt a urinary tract infection and ask me to do a urine R/E and C/S and a USG of the Kidney,Ureter,Bladder region.I have done these tests at regular
intervals since XXXXXXX 01, 2015 and before I upload the reports for your reference let me tell you my complete story that might also explain a lot of these things:

Before the month of January this year, I just knew the meaning of the word MASTURBATION. Because of living alone and having less social contacts and much of a work load, I unfortunately got addicted
to PORN, SEXCHATS, CAM SEX etc. Once I started rubbing my penis while doing sexchat/watching porn, I felt such great pleasure that I forgot everything about my duties
in the world that I am living in and got involved almost on a daily basis in pleasuring myself by whatever visual, manual means by sitting (for long hours,
sometimes 10-12 hours at a stretch)in front of a laptop with a high speed Internet Connection.I never knew about the right technique of masturbation, I did the act without any lubrication, using unwashed hands and
when I wanted to ejaculate, I used to start rubbing the foreskin of my penile head (the most pleasure giving sensitive part of my Penis)continuously and I ejaculated
in no time doing that.After I ejaculated, I just cleaned the place where I ejcaulated but NEVER cleaned my Penis. The next day whatever cleansing my Penis got was just
by the water that used to drop on it during bath. I NEVER retracted my foreskin and never cleaned my glans because I never knew that this must be done.

So, after having gotten lost in my own world for 5 complete months from January first week to May last week, I started feeling deprived of energy and I held my masturbation and ejaculation
responsible for this . As such , I totally stopped masturbating and porn for a week in the last week of May and since XXXXXXX first week I started getting the following:

a>.DAILY NIGHTFALLS (SOMETIMES TWICE IN THE SAME NIGHT)
b>.CHRONIC FATIGUE
C>.BURNING SENSATION IN THE PENIS FOREHEAD WITH A STRONG DESIRE TO URINATE AND SMALL VOLUMES OF URINE COMING OUT

And then started my doctor's visits and tests:

1>.First I googled and found a Sexologist the visit to whom further increased my troubles. He told me that semen was coming out in my urine and that I had a Urinary Tract
Infection. He prescribed me Ayurvedic medicines the total cost of which was 17000 and the duration of those medicines was 1 month. He did not even properly explain
the need of individual medicines and their associated cost in the long list of medicines.I clearly understood that the Doctor wanted to make quick money from me and came back without taking those medicines.

2>.Next, I visited a Urologist in Apollo Hospitals. He told me that I had absolutely nothing and seeing me worrisome, he was even ready to call up the Sexologist and
scold him for making a patient so tensed without reason. The urologist told me that I did not need to do any tests but when I told him that I was still having the burning
sensation , he advised me to undergo URINE R/E and C/S and USG KUB. TO my greatest astonishment, both the reports came out normal.The Doctor told me that if Semen had been
coming out in Urine or if I had an infection, it would have been confirmed by the Urine Reports but since the Reports contained nothing, I did not need to worry.

3>.Although the reports came normal I was still feeling uneasy and having symptoms I never had otherwise in my life. I visited a Homeopath who gave me
ADEL 36 POLLON Drops (for the nightfall issue)
Cantharis and Burguris solution
His medicines cured the nightfall thing but the burning was still there. The doctor ensured me that the burning would go eventually so I believed him and continued.

4>.After suffering from burning for around a month, in the first week of July, I thought that if the test reports came negative and I am still having the burning sensation, something might be wrong
with the skin of my Penile forehead since the burning was more there. As such, I visited a Dermatologist in the Apollo Hospitals. He asked me to retract my penile foreskin. I had
a very tight foreskin and when I retracted my foreskin till about half of the Head's length, we both saw some white matter stucked to the head in places.
The Dermatologist told that the accumulated White matter is called Smegma and since I never cleaned it off this accumulated Smegma caused the infection and burning. He gave me two ointments
to be applied by retracting the foreskin behind the head (Candid B to be applied at Night and Candid to be applied after morning bath). He also gave me AF-150 tablets
to be taken once daily.I continued as per the Doctor's advice and found out that by regular trials I could easily retract my foreskin behind the head when the penis was in flaccid state.

5>.These ointments did not give any relief and after four more days of burning, I got my Urine tested again in a local hospital nearby and the Report showed E. Coli growth with the Colony Count as greater than 10^5/ml of urine. The Homeopath saw the sensitivity report and advised me to take MARTIFUR MR 100 mg since the E.COLI was sensitive to
Nitrofurantoin. The medicine gave me a lot of relief and 90 % of burning disappeared in the first five days and I started getting happier.But On the sixth and seventh day , the burning started again.

6>. On the eighth day, I again did a Urine C/S and the Report showed E. COLI growth as 45000/ml of Urine. But the bacteria had became resistant to Nitrofurantoin. As such, based
on the Sensitivity Report, the homeopath asked me to take Azithral 500 mg because the bacteria was sensitive to Azithromycin. I took Azithral 500 mg for 8 days
but the burning was more or less the same with Azithromycin and my stool had become watery that further added to my troubles.I have a habit of googling things and I
found that during UTIs Uriliser syrup might be helpful, so I asked my Homeopath if I could take Uriliser syrup with Azithral 500 mg and he said I may have the syrup too.
So I continued these two medicines for a week but the burning was more or less the same.

7>. On the eight day, I again did a Urine C/S and the Report and a USG KUB in the same local hospital.The Ultrasound Report showed no evidence of E.COLI. On the contrary, a different species of bacteria called
Pseudomonas with a colony count of 48000/ml of Urine showed up. The homeopath named my condition as Recurrent UTI and based on the sensitivity Report, he advised me to
take Norflox 400 mg because the Pseudomonas specie was sensitive to Norfloxacin. With a heavy heart, I asked the Doctor if these bacteria keep changing its resistance and
types how am I supposed to live a normal life and for how long should I do these cultures. To that, he asked me to take Norflox twice daily for five days and then leave
these allopathic medicines totally and switch to a homeopath alternative. He asked me to continue Cantharis drops and gave me ADEL 22 RENELIX Drops (a general medicine
for all types of Urinary Tract Infection).He asked me to continue these medicines for 15 days and then do a Culture again.He also asked me to continue taking ADEL 36 POLL ON
drops for the nightfall thing because a nightfall on any night used to put me in great tension.

8>.I finished my Norflox dosage and continued the homeopathic medicines as advised but since the relief that I got was very little,I left the city where I was
living and working and came back to my hometown because I was increasingly worried about my condition.After about 5 days of homeopathic dosage, I did a Urine
Culture again in a diagnostic centre in my hometown. They gave me the Report in 48 hours only( unlike previously where I got the report in 72 hours) and the
Report showed that I had a sterile urine after incubation with no trace of any bacteria whatsoever.

Currently I am on the same homeopathic medicines with eight more days of dosage left but my situation is more or less the same as mentioned in the first few lines of this passage
BURNING IN THE COMPLETE PENILE AREA,
FREQUENT URINATION WITH LARGE VOLUMES OF URINE COMING OUT EVERY TIME I URINATE
INCREASED SENSITIVITY TO EVEN A SLIGHTEST TOUCH TO THE PENIS

Please help me and suggest me what should I do. I am becoming increasingly worried as days are passing.The quality of my life has reduced greatly.

Have I developed a life threatening untreatable condition like Cancer ? :(
Will I never be able to live my life like a normal healthy human being? :(
Should I do a Urine Culture again in a different hospital of my hometown?
Should I do any other tests or switch to any other medicines?
Should I just increase my liquid intake and leave all medicines and hope for things to get better?


doctor
Answered by Dr. Tushar Kanti Biswas (1 hour later)
Brief Answer:
Recurrent urinary tract infection (UTI)

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

It seems you had recurrent urinary tract infection which was treated with antibiotics as per urine culture and sensitivity reports.

In case of male, recurrent urinary tract infection [in your case often persistent/ early recurrence (within 2 weeks) ] -the two- or four-glass Meares-Stamey test (urine collection after prostate massage) should be undertaken to exclude chronic bacterial prostatitis - a source of recurrent UTIs in male.

Other possibility is Urethral syndrome in which symptoms may suggest a lower urinary tract infection but there is no significant presence of bacteriuria with a conventional pathogen.Urethral syndrome may be due to a low grade infection of the Skene's glands on the sides and bottom of the urethra akin to chronic bacterial prostatitis. For chronic urethral syndrome, a long term, low-dose antibiotic treatment is given on a continuous basis.

Common advice for recurrent UTIs

Increase fluid intake and frequency of voiding, as high fluid intake alone is enough to clear symptomatic infection. Incomplete voiding is an important cause of increased susceptibility to urine infection.

Cranberry juice (drinking 200 ml to 750 ml) is also popular alternative treatment to prevent recurrent urinary tract infection.

Either you go for Homeopath or Allopathic treatment.Mixing two is not helping you.
Recurrent urinary tract infections are treatable and not life-threatening like some cancer.
A few precaution /measures as mentioned will help you normalize your life free form recurrent UTIs.

During taking taking bath retract your fore-skin and wash with soap and water. Incidence of UTIs is higher in uncircumcised males in comparison to circumcised males.
You should always use midstream early morning sample of urine for analysis & culture and preferably in reliable laboratory ( e.g. Corporate Hospital attached laboratory).

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Tushar Kanti Biswas (13 hours later)
Dear XXXXXXX Sir,

I am extremely thankful for your valuable suggestion.

I had few things to be clear about.

1>. The Cancer that I was talking about was a Penile Cancer. I have read that uncircumcised males who do not clean underneath their
foreskin by retracting develop secretions that finally become the cause of Penile Cancer. I am also an uncircumcised male with a tight foreskin
and I never used to Clean underneath until I finally started experiencing symptoms. So, can I develop this life threatening Penile Cancer thing? :(

2>.Can a Semen Culture and Sensitivity Test be used to identify Chronic Bacterial Prostatitis in place of the suggested two or four
glass method? Can I get a Semen CS done?

3>.Which test should I do to detect if I have a Urethral Syndrome?

4>. Since my right testicle burns mildly and feels different than the left one, do I need to do a Testicular Ultrasound to exclude chronic infection in the testicles (epididymitis)?

5>. I always used to give afternoon Urine for CS Test. Do I need to give early morning first urine sample collected after I wake up?

Looking forward for your most precious suggestion.

Many Thanks
doctor
Answered by Dr. Tushar Kanti Biswas (6 hours later)
Brief Answer:
Tight fore-skin :risk of penile cancer and recurrent UTIs.

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
Poor hygiene can increase a man's risk of penile cancer.
Smegma, a whitish substance that can accumulate beneath the foreskin, is associated with greater risk of penile cancer.You are having tight foreskin i.e. close to phimosis which is considered a risk factor for the development of penile cancer.
Mucosal surface of foreskin is analogous to female introitus having propensity for colonization with P-fimbriated strains of E.coli-hence greater chance of recurrent UTI in case of non-retractable foreskin.
In view of recurrent UTI,you can opt for circumcision now.If the foreskin cannot be retracted fully, you may find difficulty in performing common sexual functions,once you get married.
The Meares–Stamey test involves collection of 4 sequential urine samples. Two are taken before prostatic massage; the first from the initial 10 mL and the second from the mid-stream urine. After prostatic massage, the expressed prostatic secretions are collected, as is the initial 10 mL of urine passed after massage.Two samples after prostatic massage, is considered to be specific to the prostate. However a semen sample has higher sensitivity than an EPS ( expressed prostatic secretions )for the diagnosis of bacterial chronic prostatitis.

You can undergo Ultrasonography (USG) of testis,if there is testicular enlargement or pain to exclude epidydimo-orchitis. However CT(computerized tomography) scan is more informative about chronic prostatitis and seminal vesiculitis.
Best urine sample for culture is first urine sample in the morning as it contains overnight collection and is more likely to yield result and also collected in midstream to avoid contamination of urine from foreskin or peri-urethral area which contains commensal organisms.






Regards

Dr. T.K. Biswas M.D. XXXXXXX
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1920 Questions

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What Causes Burning Sensation In Penile Area?

Brief Answer: Recurrent urinary tract infection (UTI) Detailed Answer: Hi, Thank you for your query. I can understand your concerns. It seems you had recurrent urinary tract infection which was treated with antibiotics as per urine culture and sensitivity reports. In case of male, recurrent urinary tract infection [in your case often persistent/ early recurrence (within 2 weeks) ] -the two- or four-glass Meares-Stamey test (urine collection after prostate massage) should be undertaken to exclude chronic bacterial prostatitis - a source of recurrent UTIs in male. Other possibility is Urethral syndrome in which symptoms may suggest a lower urinary tract infection but there is no significant presence of bacteriuria with a conventional pathogen.Urethral syndrome may be due to a low grade infection of the Skene's glands on the sides and bottom of the urethra akin to chronic bacterial prostatitis. For chronic urethral syndrome, a long term, low-dose antibiotic treatment is given on a continuous basis. Common advice for recurrent UTIs Increase fluid intake and frequency of voiding, as high fluid intake alone is enough to clear symptomatic infection. Incomplete voiding is an important cause of increased susceptibility to urine infection. Cranberry juice (drinking 200 ml to 750 ml) is also popular alternative treatment to prevent recurrent urinary tract infection. Either you go for Homeopath or Allopathic treatment.Mixing two is not helping you. Recurrent urinary tract infections are treatable and not life-threatening like some cancer. A few precaution /measures as mentioned will help you normalize your life free form recurrent UTIs. During taking taking bath retract your fore-skin and wash with soap and water. Incidence of UTIs is higher in uncircumcised males in comparison to circumcised males. You should always use midstream early morning sample of urine for analysis & culture and preferably in reliable laboratory ( e.g. Corporate Hospital attached laboratory). Regards Dr. T.K. Biswas M.D. XXXXXXX