Archive for October, 2019

There’s a Fungus Among Us: Not Just a Female Problem

October 12, 2019

Andrew Siegel MD 10/12/19

“…Moss has sprouted in my damper crevices.”

Margaret Atwood, The Testaments

Yeast are single-celled microorganisms that are members of the fungus kingdom (along with molds and mushrooms). Although fungal infections are much more prevalent in women, men are not immune.  Urologists commonly see males with penile fungal infections, particularly in uncircumcised men.  Anybody who has ever used yeast to make bread understands that yeast thrive in a dark, moist and warm environment.  The space between the penile foreskin and the head of the penis provides this ideal climate for yeast growth.

Candida is a common type of yeast that normally resides as part of the flora (the zoo in and on you) of healthy people.  It particularly thrives in warm, dark and moist places such as the vagina and gastrointestinal tract. Its growth is kept in balance by the bacterial flora of the body, but when circumstances change and unbalance the bacterial ecosystem, Candida can proliferate and overgrow, causing an infection.

Candida_albicans_under_microscope

Candida albicans under microscope;         attribution of image: Netha Hussain [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)%5D

Antibiotics are among the most common factors that affect the ecosystem, unbalancing it by wiping out many of the “good” bacteria. For this reason, many women treated with antibiotics for urinary infections end up with vaginal yeast infections. Aside from causing genital infections, yeast can also cause oral thrush (a Candida infection of the tongue and oral mucosa) and cutaneous candidiasis (yeast infection of the skin). Other factors that promote yeast infections are diabetes, any circumstance that compromises the immune system, including HIV and systemic corticosteroids, exposure to a hot and humid environment, and sexual intercourse with a partner who has Candida vaginitis.

The most common type of yeast infection is due to Candida albicans and less commonly by Candida glabrata, Candida parapsilosis, Candida tropicalis and Candida krusei.

When an uncircumcised patient presents to our urology office with foreskin issues, it is not uncommonly the first clinical sign of diabetes and a simple dipstick of the urine to check for glucose will confirm newly-diagnosed diabetes.  Balanoposthitis is medical speak for inflammation of the head of the penis and foreskin, often due to yeast infection. Candida albicans is responsible for about one-third of cases of balanoposthitis.

For word-origin lovers: “Balano-,” refers to the head of the penis (or clitoris), deriving from the Greek word “balanos” meaning acorn; “posthitis” derives from the Greek “posthe” meaning foreskin + “-itis” meaning inflammation = inflammation of the head of the penis and the foreskin.

The risk factors of a warm, moist, dark environment in conjunction with the presence of glucose in the urine (a drop or two often trapped within the foreskin) provide an ideal environment for balanoposthitis. This can cause penile redness, swelling, white spots or patches, and itching, irritation and burning of the head of the penis and the inner aspect of the foreskin. Sometimes the foreskin is so inflamed and tight that it cannot be brought down to expose the head of the penis, a condition known as phimosis.

Most cases of penile yeast infections are as readily treated as vaginal yeast infections. By maintaining good hygiene and exposing the penis to light, air and dryer and cooler conditions, the treatment process will be facilitated.  Anti-fungal creams are highly effective.  Topical creams include Lotrimin (clotrimazole), Monistat (miconazole) and Spectazole (econazole).  Alternatively, oral Diflucan (fluconazole) is effective treatment for yeast infections.

Bottom Line: Genital yeast infections are not uncommon in men, tend to occur in the uncircumcised population and are readily treated with anti-fungal medications in conjunction with good hygiene and exposure to light, air and a dry and cool environment.   

Wishing you the best of health,

2014-04-23 20:16:29

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.

Dr. Siegel’s latest book is: PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families

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Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

Prostate Cancer 20/20 on Apple iBooks

PROSTATE CANCER 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families is now on sale at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

 

 

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