Penile Disorders

There are several different conditions that can affect your penis. Some are about looks. Others deal with how everything works. Some involve both form and function. You might be born with a condition that affects your penis (congenital). Other times, a condition might develop over time. And sometimes, it can happen suddenly.

Penis health is closely related to your overall health. Other conditions, like high blood pressure, depression, diabetes and stress — to name a few — can trigger some penile disorders.

We diagnose and treat all types of penile disorders, like:

• Erections that won’t go away (priapism).
• Erections that won’t rise or stay erect (erectile dysfunction or ED).
• Internal scarring that causes a painful, bent penis (Peyronie’s disease).
• Premature, delayed or retrograde ejaculation.
• Inflammation in the penis head (balanitis).
• A too-tight foreskin (phimosis).
• A foreskin caught behind the ridge of the penis head (paraphimosis).
• A penis that’s hidden under the skin of your belly, thigh or scrotum (buried penis).
• Penile cancer.

It’s important not to ignore problems, hoping they’ll go away. You’ll want to get care from expert healthcare providers. They can treat your penis disorder along with any underlying health conditions.

What to expect at your first visit

Your first appointment is a chance for your provider to get to know you and understand what’s been going on. So, you’ll want to be prepared to answer a lot of questions. Your provider may ask:

• What kind of symptoms do you have?
• How long have you had these symptoms?
• How are these symptoms affecting your life?
• Do you have any ongoing (chronic) health conditions?
• What kind of prescription medications do you take?
• Are you under any stress?
• Do you smoke?
• Do you exercise regularly?

They’ll also do a physical exam to check your overall health and take a close look at your penis.

Testing for penile disorders

To confirm a penile disorder diagnosis, we may use several different tests. Depending on your symptoms, you may have tests like:

• Bloodwork to check hormone, blood sugar and cholesterol levels and to see how well your thyroid, liver and kidneys work.
• Urinalysis to test your urine (pee) for protein, testosterone and sugar levels to see if you have diabetes, kidney problems or low testosterone.
• Semen analysis to see how much you ejaculate and the amount of sperm in the fluid.
• Doppler ultrasound to check for scarring, calcium buildup and problems with blood flow in your penis.
• Biopsy to check for cancer cells in a sample of penis tissue.

Meet Our Penile Disorders Team

Our focus on team-based care means you’ll get the most personalized treatment and best possible results. You’ll meet with providers from different specialties, based on your needs, like:

• Urologists.
• Radiologists.
• Endocrinologists.
• Pathologists.
• Oncologists.
• Psychologists.
• Sex therapists.

Your care team works together to confirm your diagnosis, plan your care and keep a close eye on your progress.

Your treatment plan depends on the kind of penile disorder you have. That’s why our team customizes everything we do to your needs and condition.

Ejaculation problems

Ejaculation problems are treatable. If it happens too quickly (premature) or too slowly (delayed or inhibited), we’ll talk about if you’re stressed, having relationship problems or having health conditions. Any of these can affect ejaculation. Then we work with you to treat any underlying causes.

If you have retrograde ejaculation, where your semen goes back into your bladder instead of out of your penis during ejaculation, it’s not harmful and can be left untreated. But it can cause fertility problems if you’re planning to have kids. We can often treat this condition with medications like decongestants or imipramine.

Erection problems

Many things can cause problems with erections. And there are different treatments, depending on the cause.

Erectile dysfunction

Getting or keeping an erection during sex (erectile dysfunction) is more common than you may think. About half of people assigned male at birth (AMAB) age 40+ have this condition.

ED can start from prostate surgery, nerve conditions or problems affecting blood flow or pressure. A penis injury can also cause it. Or things like certain prescription drugs, smoking, overusing alcohol or stress can trigger it. We focus on treating the cause. But we can also use penile injections or vacuum devices. We may prescribe medications. In some cases, we may do penile implant surgery.

Peyronie’s disease

A bent, painful erection could signal a penis injury called Peyronie’s disease. Painful scar tissue changes the shape and size of your penis. We can use surgery or injections to remove scar tissue and straighten your penis. Or we may recommend a penile implant.

Priapism

Low-flow (ischemic) priapism is an emergency condition. It happens when the blood doesn’t flow out of your penis, and it stays painfully rigid for hours — or even days. Or it can come and go, lasting longer and getting more painful (recurrent or stuttering priapism). We typically treat low-flow priapism by draining the blood or using medications to shrink blood vessels. We may do surgery if other treatments don’t work.

High-flow (arterial or nonischemic) priapism is also a lasting erection. But it isn’t rigid or painful. The best way to treat arterial priapism is to temporarily block a part of the artery (branch) that goes to your penis.

Glans and foreskin problems

If the head of your penis (glans) is red, itchy and swollen, you may have balanitis. This can happen if you still have your foreskin (not circumcised) or if you have diabetes, dermatitis, or a sexually transmitted or yeast infection. If both your glans and foreskin are inflamed, you may have balanoposthitis. In either case, you may need medications like antibiotics or antifungal drugs. In severe cases, your provider might recommend a circumcision as part of your treatment plan.

A healthy foreskin should pull back (retract) easily. But sometimes, it’s so tight that it can’t (phimosis). An infection or scar tissue from an injury can cause this. Gently stretching the foreskin by hand over a period of time can help loosen it. So can some medications. You may need surgery to separate the glans from the foreskin or we may need to do circumcision.

It’s a medical emergency when a retracted foreskin can’t return to its original position (paraphimosis). If left untreated, penis tissue can die (gangrene), and this can sometimes lead to your provider needing to remove the penis. But we first try to reduce glans and foreskin swelling using ice or by applying pressure to force out blood and fluids. We also can use medications to stimulate drainage. Making small cuts in the foreskin or doing a circumcision can also save the penis.

Buried Penis

Buried (hidden) penis is usually found in babies and toddlers, but it can happen in people assigned male at birth at any age. A buried penis is when a normal-sized penis is hidden under the skin of your abdomen (belly), thigh or scrotum. In babies and children, the condition sometimes goes away on its own. In adults, surgery may be needed. Your provider may also recommend medications, maintaining a weight that’s healthy for you and psychological counseling if the condition is causing depression, problems with sex and low self-esteem.

Penile cancer

Penile cancer is rare. But when you’re diagnosed with it, it’s important to get treatment as quickly as possible. Surgery is typically the treatment for penile cancer.

Our surgeons may try to remove only the cancerous area (microsurgery) or the cancer and maybe a little surrounding tissue (wide local excision). Sometimes, you may be able to have laser surgery, or removal of the foreskin through circumcision could be the best option for you. If the cancer has progressed, we may need to remove the penis in a penectomy. Your care team may also recommend radiation therapy or chemotherapy to attack and kill cancer cells.

Taking the Next Step

Ejaculating too quickly. Not being able to get (or stay) erect. Having a swollen, red foreskin. Finding a lump or bump on your penis. All of these are signs something’s not quite right. And the sooner you get treatment, the lower the chance you’ll have permanent damage. Our team of experts is ready to support you with compassionate care. We understand that this can be a sensitive topic to talk about. And we’re here to guide you through all your questions and treatment options.