Penile Disorders

What is the penis?

The penis is one of the external parts of the urinary system and male reproductive system. The penis has three parts:

• Root. You can’t see the root of the penis. It exists between a fibrous membrane in your perineum (the space between your anus and genitals) and connective tissue (superficial perineal pouch) in your pelvic floor. The root contains tissues that help you get an erection, which allows for penetration during sexual intercourse, and muscles that help remove urine (pee) and semen (ejaculate) from your urethra.
• Body (shaft). The shaft of the penis looks like a tube. It hangs from a joint between the left and right hip bones. It contains your erectile tissues: two tubelike chambers that run the length of the top of the penis (corpora cavernosa) and one tubelike chamber that runs along the bottom of your penis (corpus spongiosum), which also surrounds the urethra. These chambers contain thousands of spaces that fill with blood when you get an erection.
• Glans penis (head). The glans is the tip of the penis. It contains the end of the urethra (urethral meatus), which is where pee and semen exit your body. Most males have a foreskin at birth. The foreskin is an outer layer of skin that covers the glans. But some parents choose to remove their baby’s foreskin shortly after birth (circumcision).

The skin of the penis is loose and stretchy. The stretchy skin allows for changes in penis size when you have an erection.

What disorders affect the penis?

Penile disorders are conditions that can affect your ability to have sexual intercourse or pee as expected. Many different disorders can affect your penis. These include:

Priapism

Priapism occurs when you have an erection and blood can’t drain from your penis. It’s often painful and can last four or more hours. It can occur without sexual arousal or any sexual stimulation of your penis. Priapism can cause permanent damage to your penis without emergency treatment.

Penile fracture

A penile fracture is when you severely bend or hit your erection so hard that you tear your tunica albuginea. Your tunica albuginea is a strong, fibrous connective tissue layer that covers your corpora cavernosa. When it tears, you’ll often hear a cracking or popping sound and pain followed by immediate loss of your erection. You may also have bruising or blood in your pee. A penile fracture is a medical emergency that usually requires surgery.

Peyronie’s disease

Peyronie’s disease is when scar tissue (plaque) forms in your erectile tissue and causes your penis to curve, bend or lose length. The scar tissue usually forms after an injury to your erect penis, but not always. You might not need treatment if the curve doesn’t hurt or cause you discomfort. But therapies, medications and surgery can treat more severe cases.

Balanitis

Balanitis is inflammation on the head of your penis. It typically affects those who still have their foreskin because the warm, damp area between your glans and foreskin creates an ideal environment for yeast and bacteria to grow. Yeast and bacteria are the most common causes, which most people can treat with antifungal creams or antibiotics. You can help prevent balanitis by regularly cleaning and thoroughly drying the area.

Erectile dysfunction

Erectile dysfunction (ED) is a chronic (long-lasting) inability to get or keep an erection that’s hard enough to have sexual intercourse. It’s more common in people over 40. It may be the symptom of an underlying condition that affects how blood vessels deliver blood to tissues throughout your body, including your penis. Other causes may include:

• An injury to your penis or the surrounding area.
• Conditions that affect how your nerves or hormones work.
• Certain prescription and nonmedical drugs.
• Psychological and/or emotional conditions.

There are many available treatment options for ED, including medications, therapies and devices.

Ejaculation disorders

Ejaculation disorders are a type of sexual dysfunction that affects how semen leaves your body. The three main ejaculation disorders include:

• Premature ejaculation. Premature ejaculation occurs when you orgasm and release semen sooner than you or your partner would like before or shortly after starting sexual intercourse.
• Delayed ejaculation. Delayed ejaculation is when it regularly takes a long time to orgasm and ejaculate during sexual intercourse, even though you want to.
• Retrograde ejaculation. Retrograde ejaculation is when semen goes backward into your bladder when you orgasm instead of out of your urethra.

Ejaculation disorders can have many different causes — some of them may relate to your thoughts or emotions (psychological), while others may relate to your nervous system (neurological). But treatment exists for each condition, ranging from making lifestyle changes and talking to a sex therapist to switching or starting medications.

Phimosis

Phimosis is when your foreskin is so tight that you can’t pull it back from the head of your penis. It’s normal in babies and younger children (physiological phimosis). But it should loosen with age. It can also develop from skin conditions, sexually transmitted infections (STIs) and injuries (pathological phimosis). Physiological phimosis usually doesn’t require treatment. Pathological phimosis treatment may include corticosteroid creams, gradually stretching the foreskin, surgery or circumcision.

Paraphimosis

Paraphimosis is when your foreskin pulls back toward your shaft, and you can’t bring it back to its position over the head of your penis. It’s a medical emergency that requires immediate treatment because it can cut off blood flow to your penis and cause permanent damage. A healthcare provider may make a slit in your foreskin to alleviate pressure and allow you to move your foreskin back over the tip of your penis. Or they may recommend circumcision.

Penile cancer

Penile cancer is a rare type of cancer that most commonly starts on the head of your penis or foreskin. Healthcare providers and medical researchers aren’t sure what causes penile cancer. But risk factors include:

• Human papilloma virus (HPV). HPV is a virus. There are over 100 types, 30 of which can affect your genitals, including your penis.
• Smoking. Smoking and using other forms of tobacco, including vaping, increase your risk of developing cancer.
• Smegma. Smegma buildup can cause irritation and inflammation, increasing your chances of getting cancer.

Healthcare providers most commonly recommend surgery, radiation therapy or chemotherapy to treat penile cancer.

What are the symptoms of penile diseases?

Common penile disease symptoms include:

• Any changes to your penis skin, including a rash, sores, warts or bumps.
• Pain.
• Swelling.
• Discoloration (red, white, gray or purple).
• Skin rash.
• Pain when you pee (dysuria).
• Difficulty peeing.
• Bleeding on your penis.
• Blood in your pee (hematuria).
• Blood in your semen (hematospermia).
• An erection that occurs without arousal or stimulation.
• Not being able to completely empty your bladder (urinary retention).
• Changes when you ejaculate.

How do you fix penile damage?

Penile damage treatment depends on the cause and how severe your injury is. Mild damage to your penis might heal on its own without treatment. But more serious trauma may require surgery. A healthcare provider will review treatment options with you so you can make an informed decision.

How do you fix penile dysfunction?

It depends on what condition you have and its severity. Common treatment options include:

• A “wait-and-watch” approach for conditions that don’t cause any symptoms.
• Oral medications.
• Injectable medications.
• Topical medications (creams or gels you rub on your skin).
• Psychotherapy (talk therapy) with a sex therapist.
• Surgery.
• Chemotherapy.
• Radiation therapy.

What are the signs of poor penile hygiene?

Regularly washing and properly drying your penis and the surrounding areas can help prevent:

• Smegma. Smegma is a thick, white or yellow, cheesy-looking substance that often accumulates under your foreskin. It’s a combination of oils, dead skin cells, sweat and other fluids.
• Odors. Sweat, body odors, smegma, bacteria and infections can cause your penis to smell foul.
• Skin rash. A skin rash can cause irritation and painful, flaky, scaly and discolored skin.
• Dint or lint. Lint is a fuzzy collection of fibers from clothing.

Can penile disorders be prevented?

You can’t prevent all penile disorders. But the following tips can help reduce your chances of developing some kinds of penile disorders:

• Use condoms whenever you have sexual intercourse.
• Get regular STI checks and make sure any new partners get an STI check before having sexual intercourse for the first time.
• Regularly wash your penis and the surrounding areas with soap. If you have foreskin, be sure to thoroughly clean and dry the area.
• Avoid allergens and irritants that you know cause a skin rash.
• Wear an athletic cup to protect your penis from trauma during contact sports.
• Engage in healthy lifestyle habits, including eating healthy foods, being physically active and maintaining a healthy body weight for you.
• Quit smoking.
• Use medications as prescribed by a provider.
• Avoid injuries during sexual intercourse by using lubricants, guiding your penis during insertion and being careful when you switch positions.

What can I expect if I have a penile disorder?

Penile disorders can cause you to feel a wide range of emotions. Many people feel embarrassed or ashamed about symptoms that affect such a sensitive part of their bodies. But treatment exists for many types of penile disorders. The outlook for your penile condition is better the sooner you talk to a healthcare provider.

When should I see a healthcare provider?

You should go to a healthcare provider whenever you notice changes to your penis. These may include pain, discomfort or changes to your skin, erection, how you ejaculate or pee, or sexual desire (libido).

When should I go to the ER?

Go to the nearest emergency room if you have any symptoms of a penile emergency, including:

• Hearing a loud cracking or popping sound in your penis while having sexual intercourse or masturbating.
• Sharp or severe pain in your penis.
• Having an erection that doesn’t go away after four hours.
• Pain or a burning feeling when you pee.
• Bloody pee.
• Discolored or smelly discharge from your penis.

What questions should I ask a healthcare provider?

• What penile disorder do I have?
• What’s causing my penile disorder?
• What treatment do you recommend for my penile disorder?
• How long will it take for me to feel better?
• Will I have any long-term complications?
• Do I need to schedule follow-up appointments?
• Is there anything else I can do to relieve my symptoms?