Male Urethral Injury: Seeking Guidance
About nine months ago, I engaged in unprotected oral sex along with protected vaginal and anal intercourse with a new partner. We maintain regular communication and have openly discussed my ongoing concerns. Since our initial encounter, I have noticed persistent redness and swelling around the urethral opening, along with the appearance of small blood vessels during sexual arousal or activity, leading to significant irritation. Initially, there was a mild burning sensation, but now the main issues are the visible physical symptoms and the psychological impact they have caused. Despite consulting various medical professionals, including primary care physicians, urologists, and dermatologists, I have found no relief or definitive answers. I have undergone treatments for bacterial infections, fungal conditions, prostate inflammation, balanitis, and psoriasis. Below, I outline the medications and treatments I have tried, along with their respective purposes. I would appreciate any insights from individuals who may have faced similar issues or have questions that could guide further action. **Urgent Care (Initial Consultation Post-Symptom Onset)** - **Tests:** - Tested negative for trichomoniasis, gonorrhea, and chlamydia but was still treated. - **Medications:** - Metronidazole (500 mg) and Doxycycline Hyclate (100 mg). **General Practice (Multiple Consultations Over Several Months)** - **Tests:** - Ultrasound revealed no kidney or bladder abnormalities. - All urine cultures returned negative results. - Prostate exam also yielded negative results. - STI screenings done at one month and six months post initial encounter, with no new sexual activity. The only positive result was for HSV, which I was already aware of and manage with antivirals. - **Medications:** - Phenazopyridine (200 mg), Nystatin (100,000 units), Ketorolac (10 mg), Amitriptyline HCl (25 mg), Tamsulosin (0.4 mg), Azithromycin. **Urology Consultation** - **Tests:** - CT scan of the lower abdomen showed no abnormalities. - Urine culture. - **Medications:** - Clotrimazole/betamethasone and Meloxicam (15 mg). **Dermatology Consultation** - **Medications:** - Hydrocortisone (2.5%), Fluconazole, and a medication for inverse psoriasis (Zoravye?) - Note: No other eczema or psoriasis symptoms are present. **Additional Information:** - My partner was tested for STIs and found to be negative apart from HSV, which was also known and treated. - We both underwent STI panels that included mycoplasma and ureaplasma, both of which returned negative results. - HPV testing has not been conducted, but there are no typical symptoms in either of us, and my partner has been screened by an OB-GYN. - The redness and swelling tend to worsen during arousal and in warm water (like showers). - Currently, I am applying hydrocortisone cream twice daily with little success and have abstained from sexual activities for the past month. - The next step recommended by the urologist is to perform an endoscopy to examine potential urethral injury or structural issues. I sincerely welcome any advice or support!
Answers (1)
3/23/2025, 4:01:18 PM
OpenHealth AI
It sounds like you're experiencing complex, persistent symptoms that are impacting both your physical health and emotional well-being. It’s understandable to feel frustrated after consulting multiple specialists without resolution. Your detailed history suggests that there is ongoing inflammation and possible structural issues in the urethra. Here’s a brief overview followed by some actionable steps:
Main Points
- Persistent redness and swelling around the urethral opening may indicate an underlying issue, possibly related to irritation, allergies, or structural changes.
- Endoscopy has been recommended to investigate potential structural problems or injury, which can provide clearer insights.
- Symptom management and identifying triggers will be essential during this process.
Explanation
Redness and swelling around the urethra can arise from various factors, including post-inflammatory changes, irritation from intercourse or hygiene products, or even allergic reactions. The sensations you describe, such as worsening during arousal or warm water exposure, may point towards an irritant or sensitivity issue. Since you've already pursued a variety of medical treatments without significant relief, it may be helpful to focus on identifying specific triggers and managing your symptoms as you await further evaluation through endoscopy.
Next Steps
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Keep a Symptom Diary: Track your symptoms, triggers (such as specific activities, products, or foods), and any patterns. This can help you and your healthcare provider identify potential causes or effective management strategies.
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Re-evaluate Irritants: Consider the personal care products you use (soaps, lotions, detergents) and any potential dietary irritants (like spicy foods or alcohol) that might exacerbate your symptoms. Switching to unscented, hypoallergenic products may help.
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Avoid Irritation: Continue to abstain from sexual activity until your symptoms are better managed or until you have discussed the endoscopy results with your provider. During this time, avoid warm baths or showers that tend to exacerbate swelling and redness.
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Medication Review: Since you've tried numerous medications, it might be beneficial to report back to your healthcare provider about your current regimen, particularly the hydrocortisone use. If there’s no improvement, discuss alternative topical solutions or therapies tailored for inflammation or irritation.
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Prepare for Endoscopy: As endoscopy is the recommended next step, gather any questions or concerns you might have regarding the procedure. Understanding what the specialists expect to find can help you feel more at ease.
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Emotional Support: Given the psychological impact of ongoing symptoms, consider seeking support through counseling or support groups, especially those focused on sexual health or chronic conditions. This can provide you with coping strategies and a space to discuss your feelings.
Please remain engaged with your healthcare team throughout this process, and remember that you are not alone in this. Your health issues deserve attention, and with continued exploration, clarity will come.
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