Hypersensitivity of the glans penis may be due to a genetic predisposition, occurs with balanitis, balanoposthitis, phimosis, short frenulum, allergic reactions. It is observed after prolonged abstinence, against the background of hormonal fluctuations in puberty, with emotional overstrain, stress, irritation due to contact with tissue or hygiene products. The cause is established on the basis of the results of the survey, external examination, data from the lidocaine test, and additional studies. Treatment - local and general drug therapy, surgical interventions.
Hypersensitivity of the glans penis is one of the most common causes of premature ejaculation. Associated with local changes in the area of the penis. This condition should be distinguished from early ejaculation caused by psychogenic disorders, prostatitis, neurological diseases, and taking certain medications.
The cause of primary hypersensitivity is excessive innervation of the head due to an increase in the number of nerve endings that transmit signals to the dorsal nerves of the penis. This variant is observed from birth, persists throughout life, is not associated with other diseases. In other cases, increased sensitivity occurs against the background of local irritating influences or a temporary change in the psychological state, causing an increased reaction to various stimuli.
In adolescents, the etiology of temporary hypersensitivity may be an increase in testosterone levels. The condition normalizes as they grow older and with the onset of sexual activity. Subsequently, it may temporarily appear after prolonged abstinence. A possible physiological cause in people of any age is rubbing the penis with tight underwear or wearing synthetic underwear, especially in hot weather.
Sometimes short-term irritation of the head occurs when using unsuitable hygiene products, washing powder, rinse aid. It is difficult to establish the exact cause of the symptom with emotional overstrain. Both the experiences themselves and the heightened perception of signals from skin receptors against the background of excitation of the nervous system can provoke a violation.
Hypersensitivity after a recent circumcision is also the norm, in the subsequent constant friction of the head on the linen leads to a decrease in the severity of sensations. Experts point out that the sensitivity of the head in the long-term after the operation is almost halved, but the transition period can cause certain inconveniences.
Inflammation causes skin irritation and, as a result, hypersensitivity of the head. Possible etiofactors are specific and nonspecific infections, some non-infectious pathologies. Balanitis can be acute or chronic. The head of the penis is edematous, hyperemic, covered with a plaque with an unpleasant odor. Erosion may occur. Difficulties in urination, pain, itching are noted. In the chronic course, the symptoms are smoothed out.
In patients with balanoposthitis, not only the head, but also the foreskin is involved in the inflammatory process. As in the previous case, swelling, redness, pain are observed. Prepuce mobility is limited. The most striking symptomatology is found in catarrhal inflammation. Disturbed by severe pain, excruciating itching, burning during micturition. In the chronic course, the manifestations are insignificant, aggravated by the intake of alcohol. Over time, the skin atrophies, is often injured and bleeds.
Specific infections often develop when affected by candida (transmitted from women with candidiasis) and the herpes virus. Fungal balanoposthitis proceeds with the formation of deep erosions, severe infiltration and almost complete loss of mobility of the foreskin. Sometimes films are formed, the removal of which exposes the bleeding surface. Discharge is white with a sour smell.
With herpetic balanoposthitis, bubbles appear on the head and prepuce. The contents of the vesicles are initially transparent, then cloudy. After opening, light brown crusts remain. Possible general hyperthermia, intoxication syndrome, regional lymphadenitis. Balanitis and balanoposthitis with STIs complicate the course of urethritis, are observed when hygiene is not observed, immunity is weakened:
Hypersensitivity of the head of the penis
Phimosis is formed against the background of balanitis or balanoposthitis, urological manipulations, frenulum tears, STIs, abstinence from sexual activity (especially in the absence of spontaneous erections), diabetes mellitus. Accompanied by difficulty in trying to retract the prepuce, skin irritation, bleeding, hypersensitivity, pain during sexual intercourse. The nature of the discharge is determined by the cause of inflammation. With progression, dysuria is determined.
In patients with a short frenulum of the penis during an erection, a strong tension of the skin occurs. The frenulum is richly innervated, therefore, with its slight shortening, hypersensitivity of the head worries, with a pronounced one, pains are noted during intercourse. Characterized by re-traumatization with the occurrence of heavy bleeding, an increased tendency to develop inflammatory processes. Possible secondary psychogenic disorders of erection, erotophobia.
Hypersensitivity of the head is observed with dermatitis in the penis:
Establishing the causes of hypersensitivity is the responsibility of the urologist-andrologist. If you suspect STIs, allergic dermatitis, a dermatologist-venereologist, an allergist is involved in the examination. During the interview, the doctor finds out when the symptom first appeared, whether it was preceded by any diagnosed diseases or unusual changes in the head.
During an external examination, the mobility of the prepuce is assessed, signs are identified that indicate the possible nature of the violation: edema, hyperemia, cracks, vesicles, the presence of pathological secretions, an increase in regional lymph nodes. In the absence of external changes to differentiate hypersensitivity and other causes of erectile dysfunction, the patient is offered a lidocaine test.
The essence of the manipulation is to apply 10% lidocaine on the head of the penis 10-15 minutes before sexual contact. Having sex should be in a condom. If, according to the results of 3-5 tests, the duration of the act has significantly increased, this indicates in favor of hypersensitivity. When pathological symptoms are detected, laboratory tests are prescribed.
The basic study is smear microscopy. If a large number of bacteria and leukocytes are detected, ELISA or PCR is performed to exclude specific infections, microbiological analysis to determine the nature of the microflora and sensitivity to antibiotics. Assign tests for syphilis and HIV infection. With dermatitis, allergy tests are performed, the level of immunoglobulins is assessed.
Urological examination
Men with congenital glans hypersensitivity are advised to use special anesthetic gels with lidocaine, thick-walled condoms, or an anesthetic lubricant. Patients with allergic reactions are advised to wear natural linen, choose hypoallergenic hygiene products and household chemicals.
Patients with balanitis, balanoposthitis are prescribed local drugs with antibacterial or antifungal effects. Irrigation is carried out with antiseptics. The need to use systemic funds is determined individually. Depending on the type of infection, antibiotics, antivirals, and antiprotozoals may be used. With candidiasis, general therapy is indicated for patients with immune disorders.
With allergic genesis of hypersensitivity, creams and ointments with corticosteroids, antihistamines are recommended. The bubbles are opened, stewed with aniline dyes. With erosion, cracks, weeping, they are treated with antiseptics, herbal remedies with anti-inflammatory and tanning effects. In cases where changes extend not only to the penis, but also to a significant part of the body, detoxification therapy is carried out.
With pronounced erectile dysfunction, insufficient effectiveness of anesthetics, unwillingness of a patient with congenital hypersensitivity to constantly use special means to ensure normal sexual acts, microsurgical selective denervation of the penis is performed. With a short frenulum, frenulotomy or frenulectomy is performed. Patients with phimosis undergo circumcision; if circumcision is refused, preputioplasty is recommended.