Is Circumcision the Solution for My Balanitis Caused by Candida?
I'm a 28-year-old male, standing at 5'10" and weighing 176 pounds. This condition has started to take a toll on my mental well-being, and I'm feeling quite hopeless at this point. For the past three years, I've been battling balanitis, and it seems to be a constant issue, rather than just occasional flare-ups. I've experimented with several treatments, including clotrimazole, steroid ointment, and various other creams. While the steroid cream would alleviate the symptoms temporarily—usually clearing it up within two days—it also led to a reliance on it, which I wish to avoid. The only treatment I haven’t yet explored is antibiotics. A recent physician suggested that my ailment was candida balanitis and recommended circumcision as a definitive solution. However, after researching on Reddit, I've come across testimonies from other men who experienced persistent issues even after the procedure, with some stating it returned within eight to ten months. What steps should I take next? Would consulting a urologist be advisable? Is it possible to have precise testing done to identify the condition and discover an effective treatment? The thought of undergoing circumcision only to find it doesn't resolve my problem is disheartening. I hope to find a way to effectively manage or completely resolve this issue without resorting to surgery if it isn't necessary.
Answers (1)
3/27/2025, 5:30:46 AM
OpenHealth AI
It's understandable that dealing with persistent balanitis has been challenging for you, especially given its impact on your mental well-being. Let’s focus on actionable steps you can take to manage this condition while considering your options regarding circumcision.
Main Points:
- Identifying Underlying Causes: It’s essential to confirm if the balanitis is due to Candida or another cause.
- Exploring Treatment Options: There are other treatments you can explore before considering circumcision.
- Consulting a Specialist: Seeing a urologist can provide more targeted advice and testing.
Explanation:
Balanitis is inflammation of the head of the penis, often caused by infections, including Candida (a type of yeast). The treatments you've tried, such as clotrimazole and steroids, can help manage symptoms but may not address the root cause. It's important to know that while circumcision can be a solution for some, it’s not a guaranteed fix for everyone, and personal experiences vary widely.
Next Steps:
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Consult a Urologist: Schedule an appointment specifically with a urologist who specializes in genital issues. They can evaluate your condition in-depth and possibly perform tests to identify the exact cause of your balanitis.
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Consider Testing: Ask about specific tests for Candida or other infections (like possible bacterial involvement) that may be contributing to your symptoms. Knowing the exact cause can lead to the most effective treatment.
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Alternative Treatments:
- Inquire about antifungal treatments that might be prescribed beyond clotrimazole.
- Discuss non-steroidal anti-inflammatory creams that can help minimize symptom flare-ups without leading to dependency on steroids.
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Lifestyle Adjustments:
- Ensure genital hygiene by keeping the area clean and dry, as moisture can exacerbate yeast growth.
- Consider wearing breathable underwear to reduce moisture accumulation.
- Avoid irritants such as heavily scented soaps or lotions in the genital area.
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Mental Well-being Support: Since this condition is affecting your mental health, consider talking to a mental health professional. Managing stress and anxiety can sometimes alleviate physical symptoms as well.
Taking these steps can provide you with a clearer picture of your condition and help you explore more options before considering surgery. Remember, you're not alone, and effective management is achievable. Let me know if you need further clarification or specific resources.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.