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Here's another case study that may be applicable to one or all of us..

I am 22 years old and have been experiencing extreme skin irritation just inside and around the opening of my penis since February. I understand that Penile cancer is very rare, however I have no idea what to think The first Urologist called it "Hypersensitivity just inside the urethral meatus" he also said it may be a result of s-1 nerve compression.

The skin is a little red around the opening ,very sensitive to the touch, and a third urologist looked inside and said it was inflamed about a half an inch inside. It is too painful to wear boxers anymore as the rubbing from walking irritates the skin just around the opening immensely. I now wear briefs (The tighter the better to prevent rubbing) which helps, but I still can fell the irritation and think about it with most every step.

I was diagnosed with psoriasis in February by a dermatologist, but that was for the area behind the corona, and before I ever felt any pain at the tip. After using the cream for a couple weeks that problem went away and I no longer use it. However, about a week after I started using this "Pramosone 1% cream", I started having the iritation at the opening. The Dermatologist told me to use the cream there too, and that made it worse. He then had me try a hydrocortisone 2.5 %, then zinc oxide, and even did a biopsy (of the area behind the corona). The creams made it more sensitive, and the biopsy was consistent with psoriasis. He Then referred me to the first Urologist who describedthe problem as the nerve compression and said it would probably just go away. It didn't. The next urologist did a prostate exam, but couldn't get anything on the slide at put me on levaquin 500mg for 4 weeks. With no real change, we gave up on that and he referred me to a Urologist at the University of Washington Medical center. He saw the inflammation did urine tests, and for latex allergy, and found no problems. The dermatologist did a patch test, and the only thing I came up positive for was potassium dichromate. I have since eliminated that from my diet. No difference.

The only solution recommended to me has been to cauterize the urethra where it is inflamed with silver nitrate. While it is supposed to be painful, may not work, and could cause potentially harmful scarring, the really bothersome thing is, no body knows what's going on in and around there. I would do almost anything to solve the problem, but do not want to take unnecessary risks. I realize that I can't be diagnosed over the Internet, but I need to get some feedback from other professionals and victims. I can't be the only one who has had this problem.

I know this email is long, please understand that I just wanted to put the right information out there so I could get a good response. I recently used the 2.5% hydrocortisone again for a few days, and now it hurts worse than ever. It also is more sore after sex. Also, before going to the dermatologist in February, I had a bad case of jock itch (2yrs. Ago) that would not go away. One doctor recommended that I blow dry the area after showering every day. That has worked great for two years, but I don't know if that has anything to do with this. I have been tested for many of the STD's, including herpes, and have been with the same girl for over a year and a half ( she's been tested for stuff too and is clean). She has had a couple of uti's and had the cystoscopy done by one of the same urologists that I saw. She is totally fine now and none of the doctors seem to think that there is any correlation. Finally, I read some of the other forum postings, and figured from what I have read that I should mention that I have felt a painful tensing up of what I think is my prostate when I finish urinating (only once in a while), seem to dribble a lot when I am finished (I can never shake it all off), and have felt the same pain on occasion when jumping off of tall things.

Once again, thanks for your patience with this lengthy message. I would greatly appreciate any kind of response from anybody that can help, even if you just have similar symptoms.


Homer =============================================

Dear Homer,
Even though your letter is long, it is thorough and makes it a bit easier to answer. You obviously have had a complete evaluation with more than one urologist involved. It seems that most common processes have been ruled out as the cause. I believe that your concern about penile cancer, though legitimate, is unnecessary. STD's also are obviously not found to be a problem here.
The possibility of irritation as a result of reaction to the topical cremes that you have used is quite likely. These sometimes take a long time to go away, after you discontinue using them.
Wearing more tight fitting underwear instead of boxers should also help prevent the possibility of irritation due to the element of friction/rubbing.
Furthermore, you have been appropriately treated for the chance of bacterial prostatitis without any good results. What I can add to all this is the possibility of nonbacterial prostatitis(NBP). This is an inflammation of the prostate of indeterminate cause. The typical patient is a man between ages of 20 to 45 years of age with symptoms of urinary urgency, frequency as well as sense incomplete emptying of the bladder and possible hesitancy and poor and interrupted flow. The predominant complaint is pain in the perineum(crotch), scrotal pain, pain above the pubic area and urethral pain/burning particularly at the level of the meatus. Treatment may include the use of anti-inflammatory agents such as ibuprofen, use of a group of medications referred to as alpha blocking agents and sitz baths.
You need to follow up with your doctors closely. I wish you the best.

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