Pain In The Penis : Causes, Symptoms, Diagnosis & Treatment

• Why There Is Pain In The Penis
• Trauma And Foreign Bodies
• Inflammatory Diseases
• Gangrene
• Phimosis And Paraphimosis
• Fibrosis And Sclerosis Of Tissues
• Priapism
• Vascular Damage
• Tumors
• Sti
• Individual Characteristics
• Other Reasons
• Diagnostics
• Treatment
• Conservative Therapy
• Surgery

Pain in the penis occurs with injuries, inflammatory diseases, sclerotic processes, circulatory disorders, tumors, STIs. It can be localized in the area of ​​​​the trunk or head, be sharp, dull, short-term, long-term, cutting, aching, pulling, pulling, bursting. Sometimes combined with pain in the scrotum, perineum, lower abdomen. The cause of pain is determined on the basis of survey data, external examination, ultrasound results, laboratory tests. Other visualization and functional techniques are less commonly used. Self-medication before diagnosis is not indicated

Why there is pain in the penis

Trauma and foreign bodies

The following traumatic injuries can be the cause of pain:

• Injury. In mild cases, the pain subsides after 10-15 minutes. With tears of the albuginea, the pain syndrome is long-lasting, combined with edema, cyanotic-purple color of the skin of the penis, difficulty walking and urinating.
• Infringement. The pains are growing, aching, arching. The disappearance of sensitivity with a continuing violation of the blood supply indicates tissue necrosis.
• Dislocation. It is caused by a rupture of the ligaments that fix the penis to the pelvic bones. It is characterized by extremely sharp pain at the base of the penis, displacement of the cavernous bodies under the skin of the thigh, scrotum or perineum.
• Fracture. Occurs during rough intercourse. Accompanied by a sound reminiscent of the crunch of broken glass. The pains are sharp, very intense, rapidly increasing until the development of a state of shock. Complemented by deformation, hematoma formation, increasing edema of the organ.

A foreign body in the urethra causes pain in the urethra. When inflammation is attached, pain spreads to the tissues of the penis, perineum, and is aggravated by urination.

A special type of post-traumatic deformation as a result of contact with a foreign body are oleogranulomas - dense tumor-like formations at the site of the introduction of oily substances or foreign objects under the skin of the penis. Soreness appears some time after the formation of tuberosity, combined with lymphedema, erectile dysfunction.

Inflammatory diseases

Inflammation is caused by non-specific or specific (including pathogens of tuberculosis and syphilis) microorganisms, it becomes the result of hygiene violations, medical manipulations, certain features of sexual behavior. It appears in the following forms:

• Balanitis. The head turns red, swells, covered with rashes. Pain in the acute form is intense, in chronic - aching, pulling. Strengthen against the background of the formation of erosion. Combined with itching, burning, urination disorders.
• Balanoposthitis. Inflammation covers the head and prepuce. The discharge accumulates in the preputial sac. The mobility of the foreskin is limited due to edema and infiltration. With balanoposthitis in young boys, general symptoms are expressed: weakness, hyperthermia, poor sleep and appetite.
• Cavernite. Due to inflammation of the cavernous bodies, sharp pains appear in the trunk area, almost constant spontaneous erection, febrile fever, and symptoms of intoxication. Painful infiltrate is determined by palpation, which is then opened into the lumen of the urethra with an improvement in the patient's condition. In the chronic form, the pain is weak, increases during an erection.
• Urethritis. Soreness is noted around the urethra. Basically, disturbs in the course of an emiction. Mucous or purulent-mucous discharge can provoke inflammation of the surrounding skin, sometimes with the development of balanitis.

Pain in the penis

Gangrene

It is formed against the background of infected wounds, vascular disorders, immunosuppression, severe somatic diseases. The nature of the pain syndrome is determined by the type of gangrene:

• Dry gangrene. Develops gradually. Initially, severe pain is combined with blanching and a decrease in the size of the distal part of the penis. Then an area of ​​necrosis is formed, pain continues due to the long-term preservation of nerve cells and compression of the nerves by edema in the demarcation zone. The general condition is satisfactory.
• Wet gangrene. Occurs acutely. The pain is intense, increases rapidly, then decreases after tissue breakdown. Complemented by severe intoxication, weakness, drop in blood pressure, severe hyperthermia.

A special type of pathology is Fournier's gangrene, in which necrosis covers not only the penis, but also the scrotum. It proceeds according to the type of wet gangrene. Initially, weakness, fever are observed. Then edema, hyperemia of the penis and scrotum appear. The pains increase, then disappear after the necrosis of the genital organs.

phimosis and paraphimosis

With phimosis, pain in the head of the penis occurs mainly during sexual intercourse. Sometimes it becomes the result of skin irritation or trauma when trying to open the head. Infringement of the head with the development of paraphimosis is accompanied by swelling, cyanosis, sharp pains, aggravated by the slightest touch. To reduce pain, the patient spreads his legs wide, tilts his body forward.

Fibrosis and sclerosis of tissues

In patients with Peyronie's disease, pain occurs at the stage of plaque formation and increases during erection. After the final formation of the fibromatosis site (after 8-12 months), the pain syndrome significantly decreases or disappears. In patients with xerotic balanitis, pain is due to the opening of hemorrhagic vesicles, concomitant inflammation of the head. With erection, the symptom is aggravated due to phimosis.

Priapism

Pain syndrome is observed in men suffering from an ischemic form of priapism, caused by a violation of the outflow of blood through the penile veins. Pain occurs in the proximal part of the penis, spread to the perineum, supplemented by swelling and congestive hyperemia of the penis. With a non-ischemic form of priapism, an abnormal erection also persists for a long time, but there are no painful sensations.

Vascular damage

Phlebitis of the penis is formed acutely against the background of wounds, infectious diseases, accompanied by sharp pains, swelling, soreness and tension of the saphenous veins during palpation. Chronic pain syndrome is characteristic of diseases with damage to the arteries of the penis. The pains are aching, constant, can be complicated by the formation of erosions and trophic ulcers, gangrene of the penis. They are found in endarteritis and atherosclerosis. May be seen in diabetic patients.

Tumors

In case of Keira's disease, the focus is localized on the head, more often on the inner leaf of the foreskin. Soreness is insignificant, aggravated by accidental injury, infection. Patients with penile cancer complain about the presence of a tumor-like formation or sores on the head, sometimes on the foreskin, extremely rarely on the trunk. Pain at first mild or moderate, worse during urination. They increase with infection, infringement of the head against the background of developed phimosis, the development of lymphangitis.

STI

Patients with sexually transmitted infections, pain and cramps, mainly disturb during urination, are localized along the urethra, in the region of the head around its external opening. May be observed in the following diseases:

• gonorrhea;
• mycoplasmosis;
• ureaplasmosis;
• trichomoniasis;
• chlamydia;
• candidiasis;
• genital herpes.

The pain syndrome intensifies, becomes constant with the spread of inflammation to the head with the development of balanoposthitis or balanitis. Typical discharge from the urethra.

Individual characteristics

In patients with a short frenulum of the foreskin, the symptom appears against the background of an erection, due to excessive tension of the skin fold. It intensifies during sexual intercourse, injury to the frenulum during active frictions. Another feature that causes pain during sexual intercourse is the increased sensitivity of the head. In this case, the sexual intercourse itself is painless, discomfort is noted at the time of ejaculation.

Other reasons

A symptom is sometimes noted in autoimmune diseases and parasitosis, or appears due to irradiation during pathological processes in neighboring organs. Reiter's disease in the initial stages is manifested by urethritis, subsequently developing balanitis or balanoposthitis. For dermatobiasis, the formation of a painful ulcer on the head of the penis is typical. Radiating pain in the penis area are detected in the following pathologies:

• renal colic, including those provoked by stones in the ureter;
• bladder stones;
• acute and chronic prostatitis;
• colliculitis;
• cystitis in men;
• cooperitis with the spread of inflammation to the surrounding tissue.

Urologist's consultation

Diagnostics

The urologist-andrologist is engaged in determining the nature of the pathology. The doctor collects an anamnesis, establishes when and under what circumstances the pain syndrome appeared, what other symptoms it was accompanied by, how the disease developed. Important information is the presence of injuries, unprotected sexual intercourse, the use of spermicides, the relationship of pain with erection, rough intercourse, homosexual contact, attempts to prolong an erection with the help of improvised means. The examination program includes the following diagnostic measures:

• External inspection . The specialist evaluates the appearance of the external genital organs, detects deformities, swelling, discoloration, tumor-like formations, examines the sensitivity of the penis, palpates the inguinal lymph nodes.
• Ultrasound of the penis. Informative for hematomas, Peyronie's disease, tumors, inflammatory processes. It can be performed separately or in combination with vascular ultrasound. Detects foci of fibrosis, tumor-like formations, thickening of the albuginea, changes in the lumen of blood vessels, signs of arterial atherosclerosis, vein thrombosis.
• MRI of the penis. It is carried out in diagnostically difficult cases with suspected cancer, a fracture of the penis. To increase the information content, it can be performed using a contrast agent.
• Laboratory tests . In the inflammatory process, smear microscopy is performed, in the case of leukocytosis, PCR, RIF, ELISA, microbiological examination are prescribed. Patients with volumetric formations, fibrous changes are shown a histological examination of the biopsy.

Treatment

Conservative therapy

Some conditions require emergency medical care. Patients with paraphimosis apply cold to the zone of infringement, apply a bandage with a hypertonic solution and local anesthetics, and hyaluronidase is injected. After reducing pain and swelling, paraphimosis is reduced. With persistent priapism, hirudotherapy is performed on the root of the penis, a presacral or pararenal blockade is performed. In case of inefficiency, puncture of the cavernous bodies is performed.

For the treatment of diseases accompanied by pain in the penis, the following drugs are used:

• Analgesics . Recommended to reduce pain in traumatic injuries, gangrene of the penis. They are not the basis of treatment, they are prescribed simultaneously with measures to correct the underlying pathology.
• Antibiotics . Necessary for injuries, gangrene, inflammatory processes caused by bacterial microflora, secondary infection. At the initial stage, broad-spectrum drugs are used, after obtaining the results of sowing, the drug is replaced taking into account the sensitivity of the pathogen.
• Antifungal and antiviral . Indicated for inflammation of fungal and viral etiology. They are used in the form of tablets, topical agents: sprays, ointments, creams.
• Corticosteroids . Effective in inflammatory processes, accompanied by itching in the genital area. Long-term application of hormonal ointments on the prepuce and head helps to increase tissue elasticity, reduce swelling and inflammation.

In some pathologies, irrigation with antiseptics, baths with decoctions of herbs, and physiotherapeutic procedures are useful. Peyronie's disease requires complex therapy, including vitamin E, tamoxifen, pentoxifylline, other general medicines, local remedies, plaque injections, and physiotherapy.

Surgery

The tactics of surgical intervention is determined by the cause of pain:

• Traumatic injuries : opening of a hematoma, open reduction of a dislocation or reposition of a penis fracture.
• Complicated inflammatory processes : opening, drainage of abscesses in the cavernous bodies, circumcision.
• Gangrene of the penis : amputation of the penis, penectomy.
• Phimosis, paraphimosis : dissection of the restraining ring, circumcision, preputioplasty.
• Peyronie's disease : Nesbit operation, replacement corporoplasty, pliction operations, penile prosthesis.
• Short frenulum : frenulotomy, frenuloplasty, frenulectomy.
• Tumors : circumcision, scalping of the penis, partial or hollow penectomy, if necessary with perineal urethrostomy.