44 y with history of itching and little burning only on penis, fowl smell during urination, non diabetic, sperm discharge faster during sexual participation. plz suggest the diagnosis and treatment??

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? Psychosis ,treat with PLACEBO

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ED with candidial balanoposthitis (check glans penis for that)

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??Psychological

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Contact Dermatitis

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Immediate ejaculation is related to age ... Check varicosity on penis For itching Its senile puluritis Rx. Permithrin 5% overnight application Tab. Fexofenadine 180mg OD night Permithrin soap for bathing Calamine lotion for 10days whole body Tab. Albendazole 400 stat dose in night b4food

When ever a patient complains of some problem in the penis, we cannot off handedly dismiss himas purely functional. A detailed history of exposures & history of any lesion suggestive of genital herpes has to be extracted from the patient. Most of the patients attribute it to some mischievous sexual act performed earlier in life. Investigations have tobe done to rule out previous STI . When I was in gulf, I had a Bangladeshi patient with burning micturition, for which he was treated by various practitioners with various antibiotics. When Naeem by me finally, I had to do investigations for STI s. Then the patient revealed to me that all these problems were due to an earlier episode when he had sex with a female dog. I found some pus cells in the urine . Treated with an antibiotic until pusncells became nil & a course of prostatic massage which delivered pus like discharge which was found to be sterile& with proper reassurance, he became well to his satisfaction. So, this post is just to emphasise any STI to patient before labelling him to be functional , we have to do necessary investigations & never hesitate to take a detailed sexual history. The premature ejaculation can be a separate entity or due to the anxiety with regards to problem.

Pt ruled out as Diabetic (259 )and triglycerides( 481). tq somuch for valuble suggestions by all Drs.

Psychological disorders

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Foul smell during urination Check Urine , BSL Ruled out Gonococcal urethritis &/ Balanitis

Candidal Balano posthitis.

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