Q. I have burning sensation at the tip of penis with some ulcers. Kindly help.

Answered by
Dr. Samer S J Altawil
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 26, 2020

Hello doctor,

I have a burning sensation near the tip of my penis from a few days when I urinate. A few days ago, I also had some ulcer just underneath the head of my penis. Also, I am circumcised.

I am a sexually inactive 29-year-old male. It also burns near the tip sometimes when I ejaculate from masturbation. Also, during the day, sometimes, I feel the penis head feels sensitive (mostly on the left side of the penis) to the inner surface of my undergarment when there is movement. What should I do? Do I need a physical consultation with a doctor?

#

Hi,

Welcome to icliniq.com.

Ulcer is most probably caused due to friction.

Thank you doctor,

Yes, I had posted a query a few weeks ago, and you had only answered that. You suggested a cream, and it went away with it. I want to know what the burning is due to. Yesterday night, the burning got intense for a few minutes and then went down to mild without any activity. I feel like the burning is in the tube inside of my penis. What shall I do?

#

Hello,

Welcome back to icliniq.com.

Did you take any antibiotics before?

Thank you doctor,

No, I have got such burning sensation at random times before. But it mostly used to go away in hours. This time it is taking two to three days to go, but now it has been more than two weeks.

#

Hello,

Welcome back to icliniq.com.

Alright, I also expected it to go since you are not sexually active, and I gave you local application cream to reduce it, but since it is persistent, then we need to role out infection.

Thank you doctor,

The ulcer went away within two to three days. I did not have the burning sensation back then. It started sometime after that.

#

Hello,

Welcome back to icliniq.com.

You need to have a few tests before I can get the diagnosis, but bear in mind some kind of inflammation of urethra have no known cause and it is responding variably to feel medications. But first we have to screen for infections like gonococcal infection and chlamydia, syphilis, HIV and prostatic infection which is prostatitis. So we need a urethral swab for gonococcal and chlamydia, then blood test for syphilis and HIV in addition to semen for culture.

After you gave the samples for test, then you can use Doxycycline 100 mg twice daily for 14 days. This antibiotic is effective in urethritis and lower genital tract infections, but when you get results, please show it to me as management might change accordingly.


Thank you doctor,

So in terms of the test, if I understood correctly I need to do the following.

1) Urethral swab.

2) Blood test for syphilis and HIV.

3) Semen culture.

Is that correct?

Yes, I will start taking the antibiotics post these tests.

#

Hello,

Welcome back to icliniq.com.

Yes, the tests are correct. And you only start the antibiotics after you give samples to the laboratory because if you take it earlier, it will affect the lab results.

Thank you doctor,

I will get back to you when I have got the test results.

#

Hello,

Welcome back to icliniq.com.

You are welcome. Keep in touch for further doubts.

Hi Doctor,
Here are the reports of my tests. The lab doctor couldn't get a Urethral swab as there was no pus but said that it will be fine if i am doing the other tests . Also, i had a doubt, does the semen culture say anything about my fertility ?
# Hi and thanks a lot for follow up and doing tests making treating you much more accurate. Do semen culture showed positive means you have bacterial prostatitis ( infection of prostate) sensitivity is good for cefuroxime which have oral preparation. You can take tablet cefuroxime 400 mg twice daily for 4 weeks to cover the prostate u need long term antibiotics for 4 weeks. Doxycycline is also sensitive so if you started taking doxycycline as I advised before u need to continue it for complete 4 weeks .Regarding semen culture showing sperm counts and fertility it’s not possible you need to do semen microscopic analysis for fertility purpose but that should be done after completing treatment of prostatitis. So after completing treatment then u can do semen analysis then follow up to check on sperm counts and fertility.
Rest of your tests done are ok.
Please don’t hesitate to ask if you have any more questions
Kind regards

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