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Pain in the penis / penis pain

Pain in the penis / penis pain


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Penile pain can have a variety of causes, but in most cases it is an injury or inflammation of the lower urinary tract such as urethritis or cystitis. In this case, the symptoms are particularly severe when urinating, and abdominal pain, slimy-purulent discharge and fever often occur. In addition to this, there are a number of other triggers for penile pain. If these occur during the erection, for example, a so-called "penile fracture" is possible, as well as a curvature of the limb or a painful, permanent form of the erection (priapism). If the cause of the complaint is identified in good time, in most cases it can be treated well without further impairment. Accordingly, those affected should consult a doctor or urologist as early as possible to avoid chronic inflammation and long-term damage such as erectile dysfunction.

Causes of penile pain

Penile pain is mostly caused by inflammation or injury and can occur in the urethra, foreskin or erectile tissue. Here, for example, an injury to the foreskin ligament during intercourse or the urethra through catheters or other foreign bodies is possible, and the area of ​​the penis can also be affected by surgery (such as a urethral slit) or an accident, which can lead to sensations and pain .

In addition to this, they can also be caused by a so-called "wound rose" (med .: erysipelas), which refers to bacterial inflammation due to a small injury (e.g. tear wound, eczema). If this is the case, there will be sharply defined redness, feelings of tension and pain felt as warm, headache, fever, chills, nausea, a general feeling of weakness and rapid heartbeat. Inflammation of the bladder can also cause the pain to radiate into the penis, in very rare cases penile cancer can also be the cause. This usually occurs on the glans and foreskin, but can also extend to the erectile tissue, urethra, prostate or even the abdominal wall if left untreated. However, if the carcinoma is discovered early, the prognoses are usually very good, so men from the age of 45 should take a corresponding preventive check-up once a year if possible.

If the cause of the complaint can be clearly diagnosed, it can usually be treated well. If therapy is not given, however, there can be serious consequences such as a permanent erectile dysfunction.Accordingly, a urologist should always be consulted for pain in the penis in order to avoid health risks. This is especially true when the pain is acute and / or accompanied by other symptoms such as erectile dysfunction or blood in the urine (hematuria).

Pain in the urethra

If the pain in the penis occurs primarily when urinating, this can be caused by urethritis (inflammation of the urethra). In most cases, this is caused by bacteria (chlamydia, gonococci, mycoplasma, etc.) that are transmitted during unprotected sexual intercourse, but also by smear infections, for example by incorrect wiping from the anal region into the urethra. In rare cases, a weakened immune system can also be caused by viruses, unicellular organisms or fungi, and the urethra can also be irritated, for example, by a urinary catheter or by an intolerance to certain contraceptives or lubricants.

In general, urethritis can lead to the same symptoms in men and women, although these are usually different, because women often only feel an uncomfortable feeling when urinating. In contrast, the complaints in men are usually very pronounced, since they have a significantly longer urethra and the inflammation accordingly affects a larger area. It is characterized by frequent urination, which, however, is difficult and occurs drop by drop and can be very painful. A burning sensation when urinating is also possible, in addition there may be an itching and burning sensation in the urethra, abdominal pain, slimy-purulent discharge (fluorine urethralis), fever or blood in the urine.

If no treatment is given here, the inflammation can also spread to the testicles and epididymis as well as to the prostate or spermatic duct, which can lead to further complaints or, in more severe cases, to infertility. Accordingly, early treatment is very important, because if there is a chronic inflammation of the urethra, it can also scar and harden, causing a narrowing of the urethra (stricture), which is responsible for problems with urination, recurrent cystitis or an abscess in the urethra can.

Penis pain during erection

If the complaints in the limb occur during the erection, these can also result from a hematoma or a so-called "penile rupture", which is often colloquially referred to as "penile fracture" or "penile fracture". However, due to the lack of penile bone, this is not a fracture in the strict sense, but a tearing of the erectile tissue of the penis or the surrounding membrane (tunica albuginea). This injury can occur if the limb is erect and bends, which usually happens during intercourse or, more rarely, during masturbation. In addition to this, a rupture can also be caused if e.g. an erect penis is to be hidden and pressed down strongly. In very rare cases, the injury can also occur during sleep by the man lying on his limb with his entire body weight during an erection and also bending it strongly. If there is a penile rupture, bruising, severe swelling and massive pain typically occur, and the tearing of the membrane is usually accompanied by a clearly audible bang and an immediate loss of the erection.

Bending or curvature of the penis (penile deviation) can also lead to massive pain during erection or sexual intercourse. Approx. 5% of all men are affected by this, whereby a distinction is made between congenital (congenital) and acquired penile curvatures. The former are based on a genetic malformation in the womb, such as unevenly formed erectile tissue or a shortened urethra (hypospadias). The acquired form, however, often arises as a result of a chronic disease of the two erectile erectile tissue (Induratio penis plastica) or a penile fracture. The symptoms can either develop slowly or with increasing curvature or also abruptly, but penile pain often occurs at the beginning of the disease, especially during the erection. The curvature can be very different, but in most cases, when excited, there is a curvature up, down or to the side, but a kind of "kink" in the erect limb is also possible.

A so-called “priapism” can also be considered as the cause, which is a painful form of erection that lasts longer than two hours. Depending on the extent, a medical distinction is made between a "low-flow" and a "high-flow" priapism, whereby the classification results from the extent of the blood flow in the penile erectile tissue. Accordingly, in the much more common low-flow variant (90% of cases), venous blood cannot flow out of the erectile tissue, which leads to permanent erection and, after a certain period (more than 12 hours), damage to the erectile tissue or even (from 24h) can lead to permanent erectile dysfunction. Due to the blood congestion, the penis is extremely hardened, the glans discolored and soft, and there are no pulsations. Accordingly, this is always a urological emergency, which must be treated medically as soon as possible. High-flow priapism, on the other hand, arises as a result of a strong influx of arterial blood into the erectile tissue, but since the venous outflow is not disturbed here, this form of permanent erection is also not so dangerous. The pain symptoms are correspondingly less pronounced here than in the low-flow variant, and the limb is still elastic.

In about 50 percent of cases, permanent erection occurs without a recognizable cause (idiopathic priapism). For the other half, however, various triggers can be considered, for example medication (painkillers, blood pressure medication, antidepressants etc.), drugs (amphetamines, marijuana, cocaine) and alcohol abuse are often responsible. Neurological diseases (such as multiple sclerosis) or blood diseases (leukemia, sickle cell anemia, thalassemia) are also possible, as well as injuries in the perineum or genital area, which can occur, for example, when slipping from the saddle onto the central rod of the bicycle or during an operation . In the case of the latter, the treatment of an erectile dysfunction by means of a so-called "cavernous self-injection therapy" (SKAT) comes into question, although the risk is also relatively low overall.

Pain on the glans

If the pain occurs in the area of ​​the tip of the penis, acorn inflammation (balanitis) can also be the cause, often affecting the foreskin (balanoposthitis). Characteristic here are especially pain and / or a burning sensation in the area of ​​the glans and / or foreskin, redness, swelling and in some cases a very strong itching sensation. In addition, weeping spots or purulent discharge can occur. If there is a chronic inflammation, sticking or even foreskin narrowing (phimosis) often occurs. In many cases there are also superficial skin changes. Depending on the form of balanitis, these can manifest themselves, for example, through sudden reddening with small nodules and fine, dry scales, as well as through sharply defined reddish spots with a damp surface, in which there are often small hemorrhages.

Inflammation of the glans or foreskin can have many causes, but it is often an infection with pathogens such as fungi (e.g. candida, thrush), parasites (e.g. trichomonads), viruses (e.g. genital herpes, genital warts) or bacteria (e.g. Chlamydia). These can arise on the one hand through sexual contact, but inadequate genital hygiene is also possible, through which the so-called "smegma" accumulates between the glans and inner foreskin, which provides an ideal breeding ground for pathogens. In addition to this, the glans or foreskin can also ignite, for example, as a result of hypersensitivity to medication or contact allergy, in which the skin reacts particularly sensitively to direct contact with a certain substance (e.g. latex, nickel). In addition, a number of diseases such as psoriasis, diabetes or nodule (lichen planus) increase the risk of balanitis, as does a weakened immune system (e.g. HIV) or an existing foreskin narrowing. In addition, there are favorable factors such as the frequent use of alkaline soaps or intimate sprays, very tight clothing or mechanical influences such as increased friction due to frequent sexual contacts.

Therapy for penis pain

Urethritis
If the pain in the penis is caused by urethritis (urethritis), the therapy depends on the cause. If bacteria or fungi are the triggers, appropriate medications such as antibiotics or antifungal agents (antifungals) are usually used, in some cases (e.g. with chlamydia) it is also necessary to treat the life partner. If the cause of the urethritis is not an infection, further research into the cause must be carried out.For example, it may make sense to use other hygiene or contraceptive methods. In the case of very severe pain, painkillers can also be used, but in addition to drug therapy, it is also important to drink a lot and use the toilet as often as possible, even if this sometimes means severe pain. In addition, care should be taken to keep the abdomen warm and to avoid sitting for long periods on cold surfaces.If it is a sexually transmitted infection, it is also advisable to refrain from sexual intercourse until it has healed completely.

Penile fracture
If there is a so-called "penile fracture", medical help is always required, so that those affected should go to the emergency room or, if possible, a urological clinic as soon as possible. In order to avoid long-term consequences such as erectile dysfunction, a curvature of the penis or narrowing of the urethra, surgery is carried out immediately in most cases. In lighter cases, antiandrogens or sedatives against erections and compressive bandages can also be used, and physical protection and cooling are also prescribed.

Curvature of the penis
If there is a congenital curvature or deviation of the penis, a decision is made in individual cases about the need for a surgical correction, which, due to the possible risks (scarring, bleeding, loss of erection, etc.), is usually only carried out if there are complaints or severe restrictions on sexual intercourse. Even with acquired curvature, various conservative treatment methods are possible, such as taking medication, shock wave therapy or a vacuum pump. However, if there is a very strong curvature and / or the patient suffers from great pain, a surgical intervention is usually necessary to straighten the bending to such an extent that the complaints are alleviated and sexual contacts are made possible.

Priapism
If a painful erection occurs for the first time over a period of more than two hours, this is in any case a medical emergency that must under no circumstances be trivialized. Instead, a doctor or hospital should be consulted immediately in order to clarify the cause and, if necessary, to start treatment immediately. If there is a low-flow priapism, this can be treated with medication to support the outflow of blood, and an erectile tissue puncture is also possible, through which the blood is aspirated. If this does not help, vasoconstricting substances can continue to be injected directly into the erectile tissue. If this also does not lead to success, there is the possibility of a surgical intervention in which the blood drainage is made possible by means of a “shunt connection” between the penile artery and a vein.

High-flow priapism, on the other hand, is usually only slightly or not at all painful and in most cases disappears on its own. Nevertheless, even in this case, a doctor should always be consulted first so that the permanent erection can be clarified exactly. Normally, here only the observation of priapism follows, if the erection is a problem for the person concerned, conservative methods in the form of cooling and pressure bandages or the administration of anti-inflammatory drugs can also be used.

Balanitis / posthitis
If inflammation of the glans and / or the foreskin triggers the pain, treatment is primarily based on the cause. For example, if bacteria can be identified as the cause, an antibiotic in the form of an ointment is usually used in a targeted manner, whereas fungi are administered certain antifungal agents (antifungals), which, however, are also applied locally to the affected area. For example, if there is an allergy instead of an infection, cortisone preparations can also be used to inhibit the inflammation. Is the inflammation due to an existing general illness such as As a result of diabetes, it must be treated accordingly. In this context, it is advisable, especially in the case of chronic inflammation, to act early in the event of a foreskin narrowing and to remove it surgically.

In addition, patients with balanitis should take care not to use alkaline or degreasing soaps or products such as disinfectants or intimate sprays in order not to irritate the affected areas. Instead, the acorn should only be washed off with clear water or cleaned with pure olive oil. It is also advisable to change underwear and towels frequently and to clean them in the hot wash cycle, and to dispense with washcloths entirely due to possible contamination.

Naturopathy for pain in the limb

If there is inflammation of the lower urinary tract, natural remedies can often provide effective support for relieving the symptoms. Here are a number of home remedies for cystitis, such as a tea made from bearberry leaves, which has an antibacterial effect and can therefore be used sensibly at the first signs of bladder or urethritis such as burning when urinating and frequent urge to urinate. A hip bath can also work wonders in this case. For example, chamomile tea is placed in an old container and placed in the toilet bowl. Then you sit normally on the toilet seat so that the steam can directly affect the affected areas. Alternatively, a hip bath can also be used in which, for example, a bath with the addition of tin herb is taken for 30 minutes.

In addition, regular drinking of cranberry or cranberry juice has proven itself in many cases, since this prevents germs from adhering to the urethral mucosa and can therefore have a positive effect on the course of the disease. In case of inflammation of the urethra or bladder, homeopathy also recommends clematis, naphthalinum and yohimbine, other classic medicinal herbs in this case include bearberry leaves, nettle and rose hip. (No)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese

Swell:

  • Thomas Gasser: Basic knowledge in urology, Springer Verlag, 6th edition, 2015
  • National Health Service UK: Balanitis, (access: September 27, 2019), NHS
  • DGU guideline program: Interdisciplinary S3 guideline: epidemiology, diagnostics, therapy, prevention and management of uncomplicated, bacterial, community-acquired urinary tract infections in adult patients. Long version 1.1-2, 2017 AWMF register number: 043/04, (accessed 27.09.2019), AWMF
  • Guido Schmiemann, Klaus Gebhardt, Eva Hummers: Burning urination - S3 guideline and user version of the S3 guideline urinary tract infections, German Society for General Medicine and Family Medicine e.V., AWMF register no. 053-001DEGAM Guideline No. 1, (accessed September 27, 2019), AWMF
  • Armin Mainz: Invisible Haematuria (NSH), DEGAM S1 recommendation for action, German Society for General Medicine and Family Medicine e.V., (accessed September 27, 2019), AWMF

ICD codes for this disease: N48ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.


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