Penile conditions, other than the curved penis of Peyronie’s disease

There are additional problems of the penis that can develop while a man treats his Peyronie’s disease.  There are not many additional problems, but all can complicate your life more than you need at this time.

Priapism

Priapism is a persistent, often painful erection that is not associated with sexual activity and is not relieved by orgasm, lasting from a few hours to a few days.  In priapism blood enters the penis but does not leave, thus the erection is maintained.   The more common causes of priapism:

• Penile injections, as verapamil, collagenase, steroids or interferon-alpha-2b
• Drugs, such as anesthetics, antidepressants and blood pressure medications
• Alcohol or drug abuse, especially cocaine
• Spinal cord disease
• Injury to the genitals
• Blood diseases, including leukemia and sickle cell anemia

Rapid treatment for priapism is important, even without Peyronie’s disease present, because a prolonged erection can result in tissue destruction by reducing blood flow and lead to scar formation. Treatment involves removing trapped blood with a needle placed in the corpora cavernosae, as well as treating any underlying medical condition or substance abuse problem that might be present.

Balanitis

Balanitis is an inflammation of the foreskin, or skin covering the head of the penis.   Symptoms are redness, swelling, itching, rash, pain and a foul-smelling discharge in the area of the foreskin.   Balanoposthitis is a similar condition in which the glans (penis head) and foreskin are inflamed and present similar symptoms.   Both problems can occur in men or boys who are uncircumcised (foreskin has not been surgically removed).  If an uncircumcised male does not wash under the foreskin regularly, then sweat, debris, urine, dead skin cells and bacteria will collect under the foreskin and cause irritation.    Other common causes include:

• Infection – local or systemic infection with candida albicans, the yeast responsible for thrush, can result in an intensely itchy and scaly rash.  Several sexually transmitted diseases (STD), gonorrhea, herpes and syphilis can also produce balanitis in addition to their unique infections that affect other parts of the body.
• Dermatitis/allergy – Dermatitis is any inflammation of the skin often caused by contact with an allergen or irritating substance. Sensitivity to even a small amount of certain chemicals in  soaps, detergents, perfumes and spermicidal preparations can cause balanitis.
• Diabetes – When a diabetic has glucose (sugar) in the urine, this can be trapped under the foreskin and acts a rich breeding medium for many bacteria.

Treatment of balanitis depends on determining the underlying cause, improved hygiene and perhaps  circumcision if the balanitis cannot be controlled in any other way.

Phimosis and paraphimosis

Phimosis is a medical problem in which the foreskin (prepuce)of the penis is so tight, preventing it from being pulled back or retracted from the head of the penis.  Paraphimosis is a medical emergency in which the foreskin is stuck, after being rolled back or retracted, and cannot be slid back to its usual position over the head of the penis.

Phimosis is most often observed in children, and may be present even at birth.  When it occurs in an adult male it is usually caused by an infection of the reproductive tract, or scar tissue that formed as a result of injury or chronic inflammation of the prepuce.   Phimosis can also be caused by balanitis when it causes the foreskin to the scarred or tight around the head of the penis.  Immediate medical care is required if phimosis makes urination difficult or impossible.

Paraphimosis is a medical emergency because serious complications can arise if it is not treated. Paraphimosis may occur after sexual activity, a nocturnal or typical daily erection, or after trauma to the head of the penis, leading to pain and swelling, and impair blood flow. When extreme, this reduced blood flow can result in death of the penile tissue (gangrene), making amputation of the penis necessary.

Treatment of phimosis may only require gentle manual stretching of the foreskin repeated daily over a period of time.  Circumcision is often used to treat phimosis.  When the phimosis has gone on a long time the prepuce sometimes adheres to the glans.  When this happens, a surgical procedure called preputioplasty is used to separate the foreskin from the glans.

Treatment of paraphimosis focuses on rapidly reducing the swelling of the glans and foreskin, using ice and pressure applied to the head of the penis. If these simple measures are unsuccessful, an injection of medication can be used to drain the inflammation and blood from the penis, or small cuts in the foreskin are made by a surgeon to release the prepuce from behind the glans.

Penile cancer

Penile cancer is a rare form of the disease.  While the exact cause of penile cancer remains unknown, certain risk factors for cancer are known, including:

• Phimosis – Tight foreskin that is constricted and difficult to retract, discussed above.
• Uncircumcised penis – Men who are not circumcised are at higher risk for cancer of the penis.
• Smegma – Natural oily secretions from the skin of the prepuce can accumulate if not cleaned daily.   If allowed to collect under the foreskin, this results in thick, cheesy white, bad-smelling substance, known as smegma.   Smegma by itself is irritation to the prepuce and lead to inflammation and a host of other problems.
• Human papillomavirus (HPV) infection – More than 70 types of  human papillomaviruses can cause warts (papillomas).   Only a few of these HPVs infect the reproductive organs and the anal area, being passed as a STD from one person to another.
• Smoking –Cigarette smoking brings many cancer-causing chemicals into the blood stream  that affect more than the lungs.
• Psoriasis treatment – The medication and ultraviolet light used to treat can cause penile cancer.
• Age – Penile cancer occurs most commonly in men after age 50.

Common symptoms of penile cancer are sores or unusual growths on any area of the penis, abnormal discharge from the penis, and bleeding.  Surgery or radiation is commonly used to remove the cancer from the penis.

Since 2002 PDI has advocated Alternative Medicine Peyronie’s treatment options to avoid any of these complications that compromise penis health.