Penis Tips Burns.Treated With Diflucan And Antibiotic, Using Testosterone Cream. Right Treatment?

Posted on Tue, 23 Apr 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 23 Apr 2013 Answered on

Fri, 17 May 2013 Last reviewed on

Question : The tip of penis burns constantly. I have struggled with the head of my penis feeling like its' on fire the last couple of months but that seems to be better. I have been to a doctor and urologist several times. First thought bacterial and treated with antibiotics, then though fungal and treated with diflucan, now I'm told it is bxo. I have treated with Cortizone and that didn't seem to help. Now I'm using Testosterone Cream. I am wearing a jockstrap because the rubbing of my underwear seems to make it worse. I'm just wondering if the diagnoses is correct? And if so if I'm doing the right treatment? It is almost like the skin on the tip of my penis is thin and rubbed raw. I haven't had sex in two months and when I did I used a spermicidal condom. I'm wondering if it could be related to that.

Answered by Dr. G.Srinivasan (5 hours later)

Welcome to the forum.
I went through your painful history.
It is probably condom related or BXO or more commonly prostatitis.
This is confirmed by rectal examination, urine culture, semen culture and a course of antibiotics will help in the management.
Please speak to your doctor if he had not considered this as a diagnosis.
Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (1 hour later)

I went through two rounds of doxycicline. The first time I got better a week after treatment. Then my symtoms came back after sex with a spermicidal condom again. The symtoms have have stayed longer this time and I can't seem to get better. I have had my prostate checked a couple times and urine samples taken that came back negative. I have not had a semen sample checked. Is it possibly related to that? Maybe nonoxyol 9 from condom? Is bxo treatable and how long does it take? Thank you.

Answered by Dr. G.Srinivasan (30 minutes later)

Welcome back.
Could be nonoxynol-9.
Semen culture will give an input.
BXO IS a progressive disease with no specific known cause and needs careful followup with the urologist, as it may lead to stricture (narrowing) urethra.
Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (1 hour later)

Does nonoxynol-9 cause damage? How would that be treated? Is applying testosterone cream 2-3x a day the correct treatment for bxo? If so does that need to be done for an extended period of time? What would show up in a semen culture?

Answered by Dr. G.Srinivasan (2 hours later)

1. Any chemical can cause irritation - Discontinuation is good enough.
2. BXO - Hydrocortisone cream for a few months used as local application over the area is helpful. I do not advocate testosterone. More than this, followup with a urologist is a must.
4. Semen culture may show up infection which needs treatment.
Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (7 hours later)

Why do you not advocate testosterone cream over cortisone? I used cortisone for a few days after my first visit to the urologist. It seemed to make it worse. The tip got really red. Could that be related to the alcohol in cortizone cream? Also, would a certain diet help? I was told bxo is an autoimmune disease. Is there a good chance I can manage this problem? I am really struggling.

Answered by Dr. G.Srinivasan (10 hours later)

Testosterone is for androgen deficiency. BXO is not due to androgen deficiency.
Diet has no proven role.
You can manage this problem well with regular followup.
best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar