Penile Disorders

The penis can be injured in a variety of ways. Blows to the groin, such as those that occur in sports, can result in excruciating pain or injury. Cuts that result from catching the penis in a pants zipper also are common, but they usually heal quickly. Less common are job-related accidents that sever the penis, either partially or fully. Reattachment may be possible, but full penile sensation and function are rarely fully recovered.

Several types of inflammation problems may involve the penis and the urethra. Balanitis occurs when the glans, or head, of the penis becomes red and sore. Usually the cause is unknown, but it is sometimes caused by urinary tract infection or allergic reactions to clothing or detergents. In uncircumcised men, the irritation may result when the foreskin is narrow or difficult to retract, and secretions become trapped beneath the foreskin.

A more severe form of chronic inflammation, called balanitis xerotica obliterans, produces a hardened, whitish area near the tip of the penis and over the opening of the urethra. The cause is often unknown but may be an infection or an allergy. Antibacterial creams may cure the inflammation, but often surgery is required to open the urethra.

Phimosis

Phimosis is shrinking or tightening of the foreskin. This is normal in a newborn or an infant, but the foreskin usually loosens up by puberty. In older men, the condition may result from prolonged irritation, and it may interfere with urination or sexual activity. Phimosis may be associated with penile cancer. The usual treatment is circumcision (surgical removal of the foreskin).

Paraphimosis

Paraphimosis is constriction of the head of the penis by an extremely tight, retracted (pulled back) foreskin. This often occurs as a result of phimosis (see above). Swelling and pain occur if the foreskin cannot be returned to its normal position over the head of the penis. The constriction also can cause loss of blood flow to the head of the penis, which is a medical emergency that is usually treated by circumcision.

Peyronie's Disease

In some men, the penis becomes curved during an erection. This condition is called Peyronie's disease. The cause is unknown, but fibrous or scar tissue forms inside the penis and causes it to bend at an angle during an erection. This painful condition makes sexual penetration difficult or impossible. The disease often resolves itself over several months. Vitamin E is the first-line treatment for this condition. Injections of corticosteroids into the affected area are sometimes helpful. Ultrasound therapy also has worked for some men. Surgery may cure the disease, but it can cause further scarring and make the condition worse or cause erectile dysfunction.

Priapism

Another rare and not well-understood disease is priapism, a painful, persistent erection not brought on by sexual desire or stimulation. The underlying cause (possibly drugs, blood clots, a tumor in the pelvis or the spine, infection of the genitals, sickle-cell disease, or leukemia) results in blood vessel and nerve abnormalities that trap blood in the penis during an erection. Immediate relief comes from draining excess blood from the penis with a needle and a syringe and irrigating the spongy tissue of the penis with an antihistamine fluid to wash out any clots or other blockage.

Penile Cancer

Penile cancer is the growth of cancerous cells on the skin and in the tissues of the penis. It is rare in the United States—about 1,000 cases are reported each year, accounting for fewer than 0.02 percent of all male cancers in the nation. However, 25 percent of those who develop the disease die of it. Penile cancer is linked

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