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Penile Disease

The penis serves as an external passage for the expulsion of urine and semen from the body. Conditions affecting the penis encompass priapism, balanitis, penile fracture, penile cancer, and erectile dysfunction. Treatment varies depending on the specific condition and the urgency with which medical attention is sought.

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What is the penis?

The penis serves as both an external component of the urinary and reproductive systems for individual males. Comprising three main parts:

1. Root: This segment, concealed from view, resides within the perineum, nestled between a fibrous membrane and connective tissue in the pelvic floor. It houses tissues essential for achieving erection, facilitating penetration during sexual activity, as well as muscles aiding in the elimination of urine and semen from the urethra.

2. Body (shaft): The visible portion of the penis resembles a tubular structure suspended from the joint between the left and right hip bones. Within it lie the erectile tissues—two tubelike chambers along the top (corpora cavernosa) and one along the bottom (corpus spongiosum), encompassing the urethra. These chambers comprise numerous spaces that fill with blood during erection.

3. Glans penis (head): The glans, situated at the tip, houses the urethral meatus, through which urine and semen are expelled from the body. At birth, most individual males possess a foreskin covering the glans. However, some parents opt for circumcision to remove this foreskin shortly after birth.

The skin of the penis is characterized by its loose and elastic nature, allowing for adjustments in size during erection.

What conditions affect the penis?

What conditions affect the penis?
Penile disorders encompass various conditions that can disrupt sexual activity or urination. These disorders include:

Priapism:
Priapism entails an erection where blood cannot properly drain from the penis, often leading to prolonged and painful erections lasting four hours or more. It can occur spontaneously, without sexual arousal, and necessitates immediate medical attention to prevent permanent damage.

Penile fracture:
A penile fracture occurs when the tunica albuginea, a fibrous tissue layer covering the corpora cavernosa, tears due to excessive bending or trauma to an erect penis. This results in a sudden loss of erection accompanied by a cracking sound, pain, bruising, and possibly blood in the urine, requiring urgent surgical intervention.

Peyronie’s disease:
Scar tissue formation (plaque) within the erectile tissue causes Peyronie’s disease, leading to penile curvature, deformity, or shortening. While mild cases may not require treatment, more severe instances may necessitate therapies, medications, or surgical intervention to alleviate discomfort and restore function.

Balanitis:
Inflammation of the penis head, or glans, characterizes balanitis, often occurring in individuals with a foreskin due to the favorable environment for yeast and bacteria growth. Treatment typically involves antifungal creams or antibiotics, with preventive measures including regular cleaning and thorough drying of the area.

Erectile dysfunction (ED):
ED refers to the persistent inability to achieve or maintain an erection sufficient for sexual intercourse, often associated with underlying medical, psychological, or lifestyle factors. Treatment options range from medications to psychological counseling and lifestyle modifications.

Ejaculation disorders:
These disorders affect semen release and include premature ejaculation, delayed ejaculation, and retrograde ejaculation, each with various potential causes and treatment approaches, such as therapy or medication adjustments.

Phimosis:
Phimosis occurs when the foreskin is too tight to retract over the penis head, potentially stemming from physiological factors in children or pathological conditions in adults. Treatment may involve corticosteroid creams, gradual stretching, or surgical intervention.

Paraphimosis:
In paraphimosis, the foreskin becomes trapped behind the glans, requiring immediate medical attention to prevent circulation impairment and tissue damage, often managed through manual reduction or circumcision.

Penile cancer:
A rare malignancy starting on the penis head or foreskin, penile cancer's causes remain uncertain, although risk factors include HPV infection, smoking, and poor hygiene. Treatment typically involves surgical removal, radiation, or chemotherapy.

Symptoms and Causes

What are the symptoms of penile diseases?
Typical symptoms of penile diseases encompass:

- Alterations in penile skin such as rash, sores, warts, or bumps.
- Pain.
- Swelling.
- Discoloration (red, white, gray, or purple).
- Skin rash.
- Painful urination (dysuria).
- Difficulty urinating.
- Penile bleeding.
- Presence of blood in urine (hematuria).
- Presence of blood in semen (hematospermia).
- Spontaneous erection unrelated to arousal or stimulation.
- Inability to fully empty the bladder (urinary retention).
- Changes in ejaculation patterns.

Management and Treatment

How do you repair penile damage?
Treatment for penile damage varies depending on the cause and severity of the injury. Minor damage may resolve spontaneously without intervention, while more severe trauma might necessitate surgical intervention. Our Urologist will discuss treatment options with you to help you make an informed decision.

How can one address erectile dysfunction?
Addressing penile dysfunction varies depending on the specific condition and its severity. Treatment options may include:

1. Adopting a "wait-and-see" strategy for asymptomatic conditions.
2. Oral medications.
3. Injectable medications.
4. Topical applications such as creams or gels.
5. Psychotherapy sessions with a sex therapist.
6. Surgical interventions.
7. Chemotherapy.
8. Radiation therapy.


What are the indicators of poor penile hygiene?
Consistently washing and thoroughly drying your penis and its surroundings can aid in preventing:

1. Smegma: A thick, white or yellowish substance resembling cheese that commonly builds up beneath the foreskin, comprising oils, dead skin cells, sweat, and other fluids.
2. Odors: Sweat, bodily odors, smegma, bacteria, and infections may contribute to a foul smell emanating from the penis.
3. Skin irritation: Poor hygiene may lead to skin rashes characterized by discomfort and the presence of painful, flaky, scaly, and discolored skin.
4. Lint accumulation: Lint, comprised of fuzzy fibers from clothing, may gather in the penile area if hygiene practices are lacking.

Prevention

Is it possible to prevent penile disorders?
While it's not always feasible to prevent every type of penile disorder, incorporating certain practices into your routine can help mitigate the risk:

1. Consistently use condoms during sexual activity.
2. Undergo regular STI screenings, and ensure new partners do the same before engaging in sexual intercourse.
3. Maintain good hygiene by regularly cleansing the penis and surrounding areas with soap, paying extra attention to cleaning and drying the foreskin if present.
4. Steer clear of known allergens and irritants that can trigger skin rashes.
5. Wear protective gear like an athletic cup during contact sports to safeguard against penile trauma.
6. Adopt a healthy lifestyle encompassing nutritious eating habits, regular physical activity, and maintaining a suitable body weight.
7. Quit smoking, as it can exacerbate the risk of penile disorders.
8. Adhere to prescribed medication regimens as directed by a healthcare professional.
9. Minimize the risk of injury during sexual intercourse by utilizing lubricants, guiding the penis during insertion, and exercising caution when changing positions.

A Message from NU Urology and Andrology Clinics

Many individuals find it challenging to discuss issues related to sensitive parts of their bodies, and the penis is no different. However, there's no need to feel ashamed if you experience symptoms affecting your penis. Treatment options are available for most penile disorders. Seeking assistance from our Urologist promptly is crucial for most conditions. The sooner you address your penile disorder symptoms with our urologist, the sooner you can receive a proper diagnosis and begin to feel better.

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