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What can I do for my penis pain and hourglass deformity?

Posted on by Dr.Herazy

Dr. Herazy,

About 5 years ago, i was 20 years old. I had a healthy penis and a healthy sex life. I had some hair follicles/ bumps on the under side of the shaft that i would occasionally ( for some odd reason ) pick at. I had no problem with them aestetically. You could barely notice them even if you were looking for them. I just would pick at them like someone picks at blackheads or pimples on their face. I picked at one bad enough to where it scabbed up, which i had never done before. When this happened, before it had a chance to heal ( maybe 3 or 4 days later) i was picking at the spot again, and a little white nodule appeared and i scraped at it thinking it was a hard secretion of some kind. Instantly i lost feeling in my penis, and i panicked. There was not really any pain, but i didnt feel anything, and i could not get an erection. I could touch my penis with my finger and in some spots could not feel the touch at all and in other spots it was just dull. I went to the emergency room worried that i did something serious even though everything that happened was pretty superficial and just below skin level. After talking with a doctor, he couldnt explain why i lost feeling, but he assured me that i could not have damaged any nerves that shallow, and to relax and soon enough i would be able to get an erection. So, i did just that, and what do you know, the next day i relaxed and was able to get an erection. The problem was i still couldnt feel things as well as i use too. I figured that would pass as well. For the next few months i dealt with this minor nuisance. The amount of feeling i had in my penis would fluctuate day by day, nothing to serious, but something wasnt right. Also, the wound never seemed to close up correctly. To this day, 5 years later, it looks like an open hair follicle where the skin did not heal correctly and i can still see the little white nodule that i once picked at. One day a few months after the initial incident me and my girlfriend, now my wife, had sex three times. The next day i woke up, and my problem had gotten worse. The feeling of numbness was now worse, and now the head of my penis had a lot of numbness, which i forgot to mention was not the case previous to this. Also the head of my penis became discolored suddenly, overnight. It was just a slight discoloration around the sides and back of the head. The middle top part about the same size area as my finger tip was still the same color. This one area had normal feeling, whereas the slightly discolored area had much less feeling. There was a definite correlation. The day after that when it did not go away i scheduled an appointment with a urologist, and i went to see him that week. He basically told me nothing was wrong, and it was in my head. He told there is no way i damaged my penis from what i described, and there was nothing wrong with the color of the head of my penis. I understood that it was within a normal color range, but what i tried to explain to him is that my penis head was usually just a solid pink same normal color. Overnight, this tinted darker discoloration appeared, and it correlated with less feeling in these areas. He completely dismissed the notion. To ease my worries he sent me to a neurologist. All this guy did was have me do some standard normal tests someone would test for normally with a neurological injury and tell me i was fine and collect like 250 bucks of my money. No help at all. I gave up for the time being, and just lived with the difference in feeling. Sex was still good at times, but not so good at other times, and now after sex there was a recover process. I use to be able to have sex every day or two times a day or masturbate early in the day and then have sex at night. I couldnt do this anymore. There was never any pain during sex, but after sex there was irritation and soreness, and it usually took a day or so to recover. So i would just have sex once or twice a week. The sex itself would not hurt me. Ejaculation is what seemed to cause the pain and irritation inside of my penis. For maybe a year it stayed around the same. Then all of a sudden again, there was a new change. I masturbated earlier in the day, and then had sex at night and all of a sudden it got worse the next day. The feeling on the surface was worse, and now i would have weird feelings throughout the day where i would feel like i was on the verge of ejaculating just riding in my car, or walking around. There was something going on inside, possibly with my erectile tissue, causing these feelings. Also, i stopped masturbating for a long period of time after this because it appeared to make it worse at the time. I would ejaculate by becoming aroused and just touching my penis when very aroused due to my new feeling i was able to achieve this because i could now ejaculate easier and faster, with no movement of my hand on my penis. In the past, before my "injury", i could sit around all day and try this if i wanted to and nothing would happen. This was not a good thing. When i would have this feeling on a regular basis at work or in a car, it become extremely annoying, like an itch. Also, the pain and irritation was worse now and become a nuisance, and now all of a sudden there was a new symptom more then a year in. The area right under the head of my penis seemed to be more hardened. Especially after sex. I could squeeze the bottom half of my penis with my thumbs with it soft and it was really soft and spongy. Above that from an inch below the head up to the head it was much harder all the way around. Especially shortly after ejaculating when it was the most irritated. For a while it seemed to just get gradual worse with the hardness, and the sensitivity and feeling varied day to day, and occasionally it would get much better which gave me hope that it was recovering. I would abstain from sex or masturbation during this time period, but a few days later it would revert back to how it felt before with the lack of sensitivity and irritation. Also, each time my symptoms got worse, i lasted shorter in bed. I would not have much feeling and my girlfriends vagina did not feel great anymore, but because i had that weird tingle that i walked around with all day i would sometimes ejaculate after a few hard thrusts, or i would have to cut it back and switch positions. The sex just was not comparable anymore to how it use to be. Over the last couple years it has been pretty much sustained with no significant change. One this i forgot to mention is i do have two benefits up until now that some others i am reading about do not. number one, i always can get a full erection. Number two, my erection is not curved. Still, the hardness got worse, and there seems to be a few little bumps or nodules under the skin in my upper shaft. Also when my penis is completely hard it looks straight, the only difference is on the right side of my upper shaft even though my penis does not bend, it is abnormal in the sense that it seems that the line is not smooth and straight up to my head any longer. It is ridid and dips in and back out slightly, not even really visible without pointing it out. Also when i am getting erect but not fully erect the penis will be bent to the right in a way that it never use to, but when i am fully erect there is no bend. Also, when it is in between flaccid and full erect, i can see the hourglass shape and a slight dip on the right side of my shaft in the middle right at the beginning of where the plaque seems to be. I think that i dont have a bend because the plaque is on all sides, thus the hourglass shape. My most recent development that is scaring me more then any of the other is there is now constant pain just on one side of my penis. It is after, during, and before sex. My problem would never bother me during sex previously, it would just shorten the length of time we could have sex and afterwards be irritated and require a day or two of recovery. It effected my sex life, but there was no pain during sex. Now, all of a sudden, 5 years later, this disease still continues to every once in a while get worse. The upper half of the shaft seems to get harder, the bend seems to be more when flaccid and in between flaccid and erect, although there is still no bend while erect. Worst of all this pain now is scaring the shit out of me. I forgot to mention that i went to that same urologist twice, and then finally went to another urologist, and they all blew me off. The one saw me, and then gave me my money back and told me i did not have Peyronies, because i came to him with this diagnosis after my penis started to get hard spots and develop and hour glass shape. Also, it seems my penis has shortened slightly but this does not bother me so much. What does bother me is this new pain inside my penis on the left side that hurts during sex. After 5 years of this disease progressing it really has taken its toll, and for the first time it is now severely affecting sex. Will this keep progressing?  Is there anything i can do?  Does my disease continuing to progress have anything to do with that original wound that seemed to heal weird and remain slightly open? I look down at my penis when it is in pain and i cant fathom what has happened to me. I am 25, and i feel like i have a penis full of damage and scar tissue. Until now, i would have some days where my penis felt pretty good once in a while which gave me hope that this may be reversible some day. Now that hope is gone because this pain and irritation in the left side of my penis deep inside never goes away and its very constant. It just gets worse after sexual activity, and recovers slightly over the next few days. Is it possible the inflammation has caused penile cancer? Should i go back to the doctors again just to have them too me there is nothing wrong with my severely damaged penis? I still hold out hope because i still get full hard erections and there is no bend when fully erect, but all of this numbness, pain, and hardening among many other things is depressing me so badly. After 5 years i thought i learned to live with it, but this no pain i cant take? My main concern is there a possibility that i have penile cancer, since the pain on the left side seems to be worse right at the top of the shaft by one of these small bumps. It is not localized to the spot though, and when i press on the bump, the bump itself doesnt hurt. I wish i could do something to make all of this better, or just take a few steps back to where it was maybe halfway through this process. Any help is appreciated, thanks.

 

Greetings,

Several of your symptoms make your condition sound very much like Peyronie's disease (shortened penis, penis pain, hourglass deformity, presence of "hard spots," although you report one urologist said you have the condition and another said you do not.  I suggest you get a third opinion to break the tie.   One of these two is obviously wrong, but at this point you do not know which of the two it is.

What you describe does not sound like cancer.

If it turns out you do have PD I suggest you get yourself on an Alternative Medicine plan of self-treatment to increase your ability to heal and repair your Peyronie's scar – if that is what it turns out to be.

Lastly, if it turns out you do have Peyronie's disease I doubt it was caused by your picking five years ago at the superficial white spots.  These are known as Fordyce's spots, and they are common, normal and natural 1-3 mm structures that most men have on the penile shaft and scrotum, of unknown origin.    I speculate that you probably injured yourself during sexual activity and this is the origin of your current symptoms

Please let me know what you learn after your 3rd evaluation.  TRH 

Peyronie’s disease and pain in the penis

Posted on by Dr.Herazy

Penis injury during sex common cause of Peyronie’s disease 

Nothing will get a man’s attention more than when his penis hurts.

There are typically two ways in which a painful penis can develop:  after direct penis injury, or as a result of some type of medical health problem or sickness affecting the urinary system.  When the penis hurts because of suspected disease of the prostate gland, bladder or urethra there are few clear cut answers to penis pain with the exact location, duration, and quality of penis pain different from case to case, without good explanation.   You will notice that some men with prostatitis have pain at the base of the penis, while other men with the same diagnosis have pain at the tip of the penis, and other men no penis pain at all.  Men who have a painful penis are often surprised that their condition is never given a definite diagnosis to explain its cause.

This discussion will focus primarily on a particular type of painful traumatic event peculiar to Peyronie’s disease that can either cause or worsen an existing penile problem, as with an injury during intercourse.

Peyronie’s treatment

Regardless of how Peyronie’s disease starts, surgery and drugs are not always needed to reduce the pain and penile distortion it causes. Since 2002 the Peyronie’s Disease Institute has worked with people from around the world to use natural Alternative Medicine methods to help their body reverse the Peyronie’s scar naturally. While surgery is always an option, most people prefer to first use non-surgical treatment to possibly avoid the inherent risks of surgery.

Learn more about Peyronie’s disease treatment with Alternative Medicine. Another good source of information is the Peyronie’s Disease Handbook.

Medical conditions that can cause penis pain

It is important to know that several common disease conditions not related to penile injury can also cause dull and sharp pain in the penis and should not be ignored, especially if you have other unexplained symptoms related to the pelvis or urinary system:

  • Peyronie's disease
  • Bladder stone
  • Cancer of the penis
  • Inflammation of the prostate gland (prostatitis)
  • Reiter syndrome
  • Sickle cell anemia
  • Erection that does not go away (priapism) after 4 hours – medical emergency
  • Genital herpes
  • Syphilis
  • Urethra inflammation caused by chlamydia or gonorrhea
  • Infected or defective penile prosthesis
  • Infection under the foreskin of uncircumcised men (balanitis)
  • Pimples or insect bites on the head or shaft of the penis

Because any of these conditions can cause a deeply hurt penis, it is always best to rule out disease of the urinary system by going to your family doctor for a complete examination with any type of pains in the penis.  If you do not have a medical health problem, then a painful penis is usually explained by past trauma to the genitals or pelvis.  Even minor trauma can at times cause significant penile injury with varying degrees of pain and other symptoms.  One of the reasons that traumatic penis damage is often not suspected as the cause of genital pain is that there is sometimes a delayed response between the time of injury and when the penis pain begins.  It is rather common for a man to discover that a penis injury during sex that started his Peyronies disease might not cause discomfort until several weeks or months afterward.  Probably the single-most common way for PD to start is from a forcefully bent penis during sex.

Penile fracture or broken penis syndrome – Common way to hurt penis during sex

Even though there are no bones in the penis, penile fracture and broken penis syndrome are legitimate medical terms.  Both refer to a sudden and forceful bending injury of the erect penis, resulting in torn or ruptured internal tissue.  Many times a penile fracture will occur as a result of injury during sex activity when an erection is suddenly and forcefully impacted at the tip of the penis, almost like being punched in the nose.  When the force is sudden and unexpected the vulnerable shaft can painfully sustain a sharp bend, “breaking” the inner layer of penile tissue called the tunica albuginea membrane, as well as other tissues.  The forceful impact that causes a penile fracture most commonly happens during heightened sexual activity with the female partner in the superior position; other sexual positions allow for this to happen but this is the classic situation that results in a penile fracture.  Within just a second of time she will pull back too far, lose contact with the male, and then continue back down on top of the erection impacting the penis head with her pubic, inguinal or inner thigh area.  The initial immediate pain can be very mild or severe, depending on many variables, yet sufficient to tear the tunica when it is stretched tight during an erection.

The tunica albuginea surrounds the two corpora cavernosa chambers, specialized elongated masses of spongy tissue of the penis that fill with blood to create an erection.  In a penile fracture, because the torn tunica albuginea can no longer trap blood inside the penile chambers, blood that is normally confined within the penile chambers can freely leak out to surrounding tissue often resulting significant bruising and swelling, in addition to varying degrees of pain in the penis.

About half of men who undergo penis injury similar to the above, or even compression injury during a work-, sports- or auto-related accidents, will self-heal and repair the problem with the tunica albuginea without developing Peyronie’s disease.   The other half of cases will not heal, and it will slowly and gradually worsen as Peyronie’s disease develops over time.

Pain in tip of penis

Men with Peyronie’s disease sometimes have pain in the tip of the penis, although this is somewhat unusual because the pain of PD is usually located along the shaft or even base of the penis.  Although pain in the penile tip could be related to Peyronies, it is more likely due to reflex from the prostate gland; prostatitis often will refer pain to the tip of the penis.  As a point of differentiation, prostatitis will often increase urinary frequency, reduce the force and volume of urine, burning in the penile tip unrelated to voiding, reduced erectile ability, blood in the urine and semen, and aching pain is possible in the penis, testicles, rectum, perineum, groin and lower abdomen and low back.  Prostatitis can be precipitated by too frequent or too infrequent ejaculation, sexual arousal without ejaculation, withdrawal at the time of ejaculation, aggressive bike or horseback riding, excessive spicy foods, alcohol, and caffeine, as well as prolonged sitting especially in an automobile.

A similar complaint is burning at the tip of the penis.  When this occurs it suggests the possibility of an STD (sexually transmitted disease) or an infection of the urinary tract.   Generally, an STD is associated with a change of sexual partners, and can be variable from few a few subtle symptoms to marked genital pain during intercourse, discharge, itching and pain burning pain in the penis tip during urination.  STDs are serious problems that demand prompt and aggressive medical diagnosis and care.   A common urinary infection is suspected if you feel the need for frequent urination or notice that you need to urinate again within a few minutes.

Pain at base of penis

Pain at the base of the penis is perhaps most often explained as originating from a chronic bacterial infection of the prostate (chronic bacterial prostatitis).  This problem often comes and goes over time without apparent reason.   During a flare-up the penis pain can be dull or sharp, and extend to the testicles and anus as well as the pubic bone in front or the low back.  Bowel movements may be painful at this time.  It is also common to note frequent urgency of urination, pain when urinating or during ejaculation. While these symptoms are similar to an acute bacterial prostatitis, men who have a flare-up of chronic bacterial prostatitis tend to be less run down, feverish and ill-feeling than with acute prostatitis.

Nine Causes of Pain in the Penis

Posted on by Dr.Herazy

Peyronie's disease not the only cause of penis pain

Peyronie’s disease often causes pain during erection because the shortened scar tissue located in the tunica albuginea cannot lengthen, and causes pain.  Occasionally, men will also report penis pain when erect and non-erect; some men will even report never having pain during erection but only when non-erect or flaccid.

Since pain is often a part of the Peyronie’s disease landscape, let us take a closer look at penis pain that occurs only during sexual activity, with the most common causes being listed first. .

Peyronie’s disease is a common explanation when men have sexual pain, but it is not the only one. See your doctor for an official diagnosis, but here are some other culprits.

Poor sexual technique and insufficient foreplay to cause adequate sexual lubrication.  Rushing into genital penetration before the female partner is adequately prepared sexually can be painful due to the vagina being dry and too contracted.  Use of adequate sexual lubrication can be extremely helpful.

Prostatitis is an inflammation or infection of the prostate gland that can cause swelling and pain in the area behind your penis (just below your bladder), pain or burning when urinating, and painful ejaculation.

Genital herpes can cause a sore on the penis that results in very painful sex.  In addition to avoiding sexual contact with a partner during an outbreak because these sores are extremely infectious, part of the therapy for herpes is to refrain from sex in any case.

Urinary tract infections anywhere from the bladder to the tip of the urethra (urinary tube that runs the length of the penis to pass urine out of the body).  This needs to be treated rapidly, because they can spread and become very serious.

Yeast infections of any part of the urinary tract are often accompanied by itching or burning at the tip of the penis.

Allergies and dermatitis caused by sensitivity to chemicals or soaps can result in inflammation of the skin on the penis, especially for those men who are uncircumcised.

Psoriasis of is a non-infectious chronic skin condition that results in scaly, itchy and painful red patches.  These are usually treated with low-dose steroid creams. When psoriasis of the penis develops, sexual contact can be painful.

Phimosis is a condition of the penis in which the foreskin, also called the prepuce, is too tight to be completely retracted over the head of the penis.  Movement of this tight skin during sexual activity can be very painful.

Paraphimosis is a similar condition in which the tight foreskin becomes stuck behind the head of the penis.  Low grade infections can develop, and reduced blood flow to the area can occur, either or both of which are very painful.

Any pain that develops during sex should be investigated by a medical doctor.

For a more in-depth discussion about matters of penis pain, and the role of Peyronie’s disease in sexual activity, please refer to my book, “Peyronie’s Disease & Sex”