What causes phimosis with itchiness around the glans and a burning sensation while urinating despite taking medicines?

Question

Hello doctor,

I have had phimosis over the last six months. I have started getting strong itchiness in and around the glans for the past few months. When I could pull the foreskin backward before having phimosis, I had some bruises on the glans. But now after having phimosis, I cannot see the glans anymore. The itchiness is severe at times and causes a burning sensation while passing urine. There is some occasional milky discharge from the penis which seems to have accumulated within the glans. I am sure that the glans are bruised. I am a diabetic patient on medical supervision and exercises. My PP / fasting sugar and HbA1c readings taken two months back are 140, 105, and 6.8 respectively. It is normal owing to medications, regular walking, and diet control. I do not have any swelling or trauma in the groin area. I also do not have any visible ulcer formations on the tip of my penis. I got a urine analysis done recently, and there is no trace of sugar in the urine. But it is alkaline, thereby indicating UTI. Currently, I am taking Galvus Met 50mg/ 1000 mg and Metsmall 500 mg.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

Poor hygiene is the main cause of balanitis. Poor hygiene around this area combined with a tight foreskin can lead to irritation by smegma. Smegma is a cheese-like substance that forms under the foreskin if the end of the penis (glans) under the foreskin is not cleaned. This is the most common cause of balanitis. At the head of the penis, there are glands producing fluid, also called smegma, which allows the foreskin to move over the head of the penis easily. When the head of the penis is not regularly cleaned, this fluid accumulates and expels an unpleasant odor. This can be easily controlled through good personal hygiene and antibiotics. If a bacterial infection is the cause of your balanitis, you will be prescribed a seven-day course of an oral antibiotic (antibiotic tablets or capsules) such as Flucloxacillin or Metronidazole.

If untreated, the infection spreads and the foreskin swells up. Eventually, the foreskin becomes so large that it cannot retract. It becomes swollen and tight, and cannot be moved back away from the glans. Phimosis is the result of repeated foreskin infections such as balanitis.

I suggest you follow the following preventive measures.

Make sure the tip of your penis is completely dry and free of urine after urinating.
Wash the head of your penis carefully with water every day and gently clean under your foreskin.
Make sure you dry your penis thoroughly after bathing.

I hope this has helped you.

Thank you.