Sexually Transmitted Diseases/Red Meatus, discomfort, nagging feelings, and pain
QUESTION: Hi Doc, I got an issue and perhaps you can help me.
3 months ago I sustained a injury to my penis tip. The injury occurred when semen from my penis tip bonded itself to my underwear unknowingly, and I went to urinate and because I was unaware that it had basically glued itself to my underwear, was torn off. There was immediate pain and discomfort for a day or so but it went away.
Few days to 1 week later I start to notice redness, pain, and discomfort. It gets worse after sex. So I have been abstaining from sex for nearly 2 and half months now. I even toned down masturbation. The pain is localized to mostly the head but sometimes I get a twinge towards the base of my shaft. My testicles don't hurt.
I have been tested for Gono and Chlamydia, which were negative, there is no blood in urine tests and there is no discharge to my knowledge. I was also tested for UTI and bacterial infection, both of which came back negative.
I have been to 3 primary care doctors and they can't seem to nail this diagnosis. I had one tell me it was trauma and it would go away after a time, it hasn't and it's been about 3 months now. I had one tell me it could be Herpes, gave me meds, which did not help. I had another tell me it was Yeast Infection and gave me Nystatin and that didn't help either.
My symptoms are as follows;
Red meatus area around urethra
My urethral opening looks very red and slightly swollen, even down inside
Lips of penis head also look odd, possibly very slightly swollen
Pain about 3 or 4 on the pain scale, when it happens
A nagging discomfort, is this itching? It doesn't feel like itching to me but it's annoying!
urethral opening is overly sensitive
dye-like urine effect, akin to how it looks when you put food coloring in water.
Is this an STD? (I don't have reason to suspect so) or something more serious? Could it be nerve damage?
How can I treat this?
Please, help me Doc. I want my life and my penis back. This is beginning to have an emotional toil on me.
ANSWER: Ok Will, so first of all, I am a HUGE advocate for not going to more than 2 primary care providers because no one ever talks to each other anymore and you just confirmed my theory that if you see 3 different doctors, all 3 will give you a different opinion and in this case, 3 different forms of treatment, which you should've asked questions about. But that's in the past and you cant change that now. Why haven't you consulted a urologist yet? Urologists are basically experts in the reproductive system and genitalia of men specifically and would know A LOT more than a family physician. With that said, since I'm not a doctor, I can only tell you what I know.
1. You aren't showing signs of ecchymosis or intense, bruise-like swelling, and the inside of your urethra is supposed to be a little bit darker. I know mine is. As for the swelling, if you gently pull apart the urethral walls and look down into your urethra, does it still look swollen or is there a little "breathing room?"
2. You don't have an STI at all because your tests came back conclusive for that, so believe it!
3. Because the tear is basically skin damage, it could be that the skin has already healed back. I mean it HAS been 3 months right? However, the amount of nerve clusters that are located inside the shaft and glans of your penis is another matter. Yes, you could have damage some nerve endings, which take forever, if not longer to heal back and that could cause the "itchiness" sensation you're having.
I can only tell you what I know, but if you need closure and resolution then DO NOT see another family doctor! You require a specialists help at this point, but good luck to you and I'm sorry if it still hurts :(
---------- FOLLOW-UP ----------
QUESTION: Thank you John;
I haven't gone to a specialist yet because I can't afford one and people won't refer me.
I'm waiting to see if I can get on Medicaid or get SOMETHING so I can get in to see one by specifically going instead of trying to get a referral.
I told them I had been to so and so doctor and this is what they said but all I get is well we'll do our own things and run our tests etc because you didn't do it at our facility and such and such. It's
annoying honestly that they do not and did not listen to me =.=
Could you see the attached pictures OK?
The yeast infection ointment Nystatin that I was provided somewhat alleviated symptoms but now that the treatment period is over, we are right back to square one. I assume it's because it coated the tip and urethra.
After the injury sex was hurting real bad, making it throb a lot and was very painful. I quit and it's been 3 months now..
The pain and such all seems localized to the head, other then the occasional twinge towards the shaft, which I assume is Acute and nothing to worry about.
I can't tell about the breathing room thing, all I know is my urine stream doesn't appear changed. It is not cut off or lessened. No visible blood in it. Maybe it's not swollen but it's awfully red.
When I went to Urgent Care the 11th of Feb they ran all sorts of STD tests in addition to Gono and Chlamydia which I told them I had already done at another doctor and they came back negative. They ran them anyways. Jury is still out on all their tests, but I don't see any real symptoms of any STD, myself and apparently neither did you as you would have mentioned it from my pictures.
If anything it's something a Urologist needs to look at or it's an internal yeast infection.
I appreciate your time and your responses John. If you know of a way I can get an easy referral to a Urologist, I'd be glad to hear it because I can't seem to get one and I'm growing impatient and annoyed. The only way I know how is to get one from a doctor and they won't do it or go directly to one myself and I can't afford the non-insurance co-pays.
I saw everything just fine, but I still couldn't advise you what to do. I know a specialist might seem like its expensive, but I'm willing to pay anything to find out what's wrong with me! See if a specific urologist office could help you out. As far as the people at the doctor's office giving you the run around, make the appointment on your own! I've done it before with a neurologist and so can you.