Pain in the penis
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, blunt, short-term, prolonged, cutting, aching, tugging, pulling, bursting. Sometimes it is combined with pain in the scrotum, perineum, lower abdomen. The cause of pain is determined based on survey data, external examination, ultrasound results, laboratory tests. Other visualization and functional techniques are used less often. Self-medication before diagnosis is not indicated
Why there is pain in the penis
Injuries and foreign bodies
Inflammatory diseases
Gangrene
Phimosis and paraphimosis
Fibrosis and sclerosis of tissues
Priapism
Vascular damage
Tumors
STIs
Individual features
Other reasons
Diagnostics
Treatment
Conservative therapy
Surgical treatment
Prices for treatment
Why there is pain in the penis
Injuries and foreign bodies
The following traumatic injuries can cause painful sensations:
Bruise. In mild cases, the pain subsides after 10-15 minutes. With tears of the protein membrane, the pain syndrome is long-lasting, combined with edema, bluish-purple coloration of the penis skin, difficulty walking and urinating.
Infringement. The pains are increasing, aching, bursting. The disappearance of sensitivity with a persistent 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 cavernous bodies under the skin of the thigh, scrotum or perineum.
A fracture. Occurs during rough sexual intercourse. Accompanied by a sound resembling the crunch of broken glass. The pain is acute, very intense, rapidly intensifying until the development of a state of shock. They are supplemented by deformation, hematoma formation, and increasing edema of the organ.
A foreign body of the urethra causes soreness in the urethra. When inflammation is attached, the pain spreads to the tissues of the penis, perineum, and increases when urinating.
A special kind 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 lymphatic edema, erectile dysfunction.
Inflammatory diseases
Inflammation is caused by non–specific or specific (including pathogens of tuberculosis and syphilis) microorganisms, becomes a consequence of hygiene violations, medical manipulations, certain features of sexual behavior. It manifests itself in the following forms:
Balanit. The head turns red, swells, becomes covered with rashes. Pain in the acute form is intense, in the chronic form – aching, pulling. They increase against the background of erosion formation. Combined with itching, burning, urination disorders.
Balanoposthitis. The inflammation covers the head and the prepuce. The separable accumulates in the preputial sac. The mobility of the foreskin is limited due to edema and infiltration. With balanoposthitis, younger boys have general symptoms: weakness, hyperthermia, poor sleep and appetite.
Cavernite. Due to inflammation of the cavernous bodies, there are sharp pains in the trunk area, almost constant spontaneous erection, febrile fever, symptoms of intoxication. A 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 mild, it increases during an erection.
Urethritis. Soreness is noted around the urethra. Mainly, it bothers during urination. Mucous or purulent-mucous discharge can provoke inflammation of the surrounding skin, sometimes with the development of balanitis.
Pain in the penis
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. It develops gradually. Initially, severe pain is combined with paleness and a decrease in the size of the distal part of the penis. Then a necrosis site is formed, the pain continues due to the long-term preservation of nerve cells and compression of 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 the disintegration of tissues. They are supplemented by severe intoxication, weakness, a drop in blood pressure, severe hyperthermia.
A special type of pathology is Fournier gangrene, in which necrosis covers not only the penis, but also the scrotum. It proceeds according to the type of wet gangrene. At first, weakness and an increase in temperature are observed. Then there is swelling, hyperemia of the penis and scrotum. The pain increases, then disappears after the necrosis of the genitals.
Phimosis and paraphimosis
With phimosis, pain in the head of the penis occurs mainly during sexual contacts. Sometimes it becomes a consequence of skin irritation or injury when trying to open the head. The infringement of the head with the development of paraphimosis is accompanied by swelling, cyanosis, sharp pains that intensify at the slightest touch. To reduce the 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, 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 caused by the opening of hemorrhagic vesicles, concomitant inflammation of the head. With an erection, the symptom increases due to phimosis.
Priapism
Pain syndrome is observed in men suffering from an ischemic form of priapism caused by a violation of blood outflow through the penile veins. Pain occurs in the proximal part of the penis, spreads to the perineum, is supplemented by edema and congestive hyperemia of the penis. With a non-ischemic form of priapism, a pathological erection also persists for a long time, but there are no painful sensations.
Vascular damage
Penile phlebitis is formed acutely against the background of wounds, infectious diseases, accompanied by sharp pains, swelling, soreness and tension of subcutaneous veins during palpation. Chronic pain syndrome is characteristic of diseases with lesions of the arteries of the penis. The pain is aching, constant, can be complicated by the formation of erosions and trophic ulcers, gangrene of the penis. They are detected in endarteritis and atherosclerosis. They can be observed in patients with diabetes mellitus.
Tumors
In Keir’s disease, the focus is localized on the head, more often on the inner leaf of the foreskin. The soreness is insignificant, it increases with accidental injury, attachment of infection. Patients with penile cancer complain of the presence of a tumor–like formation or ulceration on the head, sometimes on the foreskin, extremely rarely on the trunk. The pain is mild or moderate at first, and increases during urination. They increase with infection, infringement of the head against the background of developed phimosis, the development of lymphangitis.
STIs
Patients with sexually transmitted infections, pains and pains are mainly disturbed during urination, localized along the urethra, in the area of the head around its external opening. They can be observed in the following diseases:
gonorrhea;
mycoplasmosis;
ureaplasmosis;
trichomoniasis;
chlamydia;
candidiasis;
genital herpes.
The pain syndrome increases, becomes permanent when the inflammation spreads to the head with the development of balanoposthitis or balanitis. Typical discharge from the urethra.
Individual features
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 increases during sexual intercourse, injury of the frenulum during active frictions. Another feature that causes pain during sexual contacts is the increased sensitivity of the head. In this case, the sexual act itself is painless, unpleasant sensations are noted at the time of ejaculation.
Other reasons
The symptom is sometimes noted in autoimmune diseases and parasitoses, or appears due to irradiation in pathological processes in neighboring organs. Reiter’s disease in the initial stages is manifested by urethritis, later balanitis or balanoposthitis develop. For dermatobiasis, the formation of a painful ulcer on the head of the penis is typical. Radiating pain in the penis area is detected in the following pathologies:
renal colic, including caused by stones in the ureter;
bladder stones;
acute and chronic prostatitis;
colliculitis;
cystitis in men;
couperitis with the spread of inflammation to the surrounding fiber.
Consultation of a urologist
Consultation of a urologist
Diagnostics
The urologist-andrologist is engaged in determining the nature of pathology. The doctor collects anamnesis, determines 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 contacts, the use of spermicides, the connection of pain syndrome with erection, rough sexual 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 genitalia, identifies 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 carried out separately or in combination with vascular ultrasound. It detects foci of fibrosis, tumor-like formations, thickening of the protein membrane, changes in the lumen of blood vessels, signs of atherosclerosis of the arteries, venous 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 produced 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 bulky formations, fibrous changes are shown histological examination of the biopsy.
Treatment
Conservative therapy
Some conditions require urgent medical attention. In patients with paraphimosis, cold is applied to the area of infringement, a bandage is applied with a hypertonic solution and local anesthetics, and hyaluronidase is injected. After reducing pain and swelling, paraphimosis is corrected. With persistent priapism, hirudotherapy is performed on the root of the penis, presacral or paranephral blockade is performed. In case of inefficiency, a puncture of the cavernous bodies is performed .
For the treatment of diseases accompanied by pain in the penis, the following medications 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 the implementation of measures to correct the underlying pathology.
Antibiotics. They are necessary for injuries, gangrene, inflammatory processes caused by bacterial microflora, attachment of secondary infection. At the initial stage, broad-spectrum medications are used, after receiving the results of sowing, the drug is replaced taking into account the sensitivity of the pathogen.
Antifungal and antiviral. They are indicated for inflammation of fungal and viral etiology. They are used in the form of tablets, topical agents: sprays, ointments, creams.
Corticosteroids. They are effective in inflammatory processes accompanied by itching in the genital area. Prolonged application of hormonal ointments to the prepuce and the head helps to increase the elasticity of tissues, reduce swelling and inflammation.
In some pathologies, irrigation with antiseptics, baths with herbal decoctions, physiotherapy procedures are useful. Peyronie’s disease requires complex therapy, including vitamin E, tamoxifen, pentoxifylline, other general medications, local remedies, injections into the plaque, physiotherapy procedures.
Surgical treatment
The tactics of surgical intervention is determined by the cause of pain:
Traumatic injuries: opening of a hematoma, open reduction of dislocation or reposition of a penis fracture.
Complicated inflammatory processes: autopsy, drainage of abscesses in cavernous bodies, circumcision.
Gangrene of the penis: amputation of the penis, penectomy.
Phimosis, paraphimosis: dissection of the infringing ring, circumcision, prepucioplasty.
Peyronie’s disease: Nesbit surgery, substitutive corporoplasty, plication operations, falloprosthetics.
Short frenulum: frenulotomy, frenuloplasty, frenulectomy.
Tumors: circumcision, penile scalping, partial or hollow penectomy, if necessary with perineal urethrostomy.
