Pain in the penis / penile pain

Pains in the penis can have a variety of causes, but most are injuries or inflammation of the lower urinary tract such as urethral or cystitis. In this case, the symptoms are especially strong when urinating, often occur also abdominal pain, slimy-purulent discharge and fever. In addition to a number of other triggers for the penile pain into consideration. For example, these occur during erection, a so-called "penile fracture" is possible, as well as a curvature of the penis or a painful, permanent form of erection (priapism). If the cause of the complaint is recognized in good time, it can be treated well in most cases without further impairment. Accordingly, sufferers should visit a doctor or urologist as early as possible to avoid chronic inflammation and long-term damage such as erectile dysfunction.

contents

• Causes of penile pain
• Pain on the urethra
• Penis pain during erection
• Pain on the glans
• Therapy for penile pain
• Naturopathy for pain in the limb

Causes of penile pain

Penis pain is usually caused by inflammation or injury, and can occur in the urethra as well as in the foreskin or cavernosum. Here, for example, a violation of the foreskin ligature during sexual intercourse or the urethra by catheter or other foreign bodies in question, as well as surgery (such as a urethral slit) or an accident, the area of ​​the penis are affected, which can cause discomfort and pain.

In addition, these may also be due to a so-called "Wundrose" (med. Erysipelas), which bacterial inflammation as a result of a minor injury (such as crack wound, eczema) is called. If this is the case, sharply defined warm redness, feelings of tension and pain may occur at the affected area; headache, fever, chills, nausea, general weakness and rapid heartbeat are also possible. A bladder infection can also cause the pain to radiate into the penis, in very rare cases, a penile cancer may be the cause. This usually occurs on the glans and on the foreskin, but can also untreated on erectile tissue, urethra, prostate or even the abdominal wall to expand. However, if the carcinoma is detected early, the prognosis is generally very good, and accordingly, men should take an appropriate preventive check-up once a year, preferably once every 45 years.

If the trigger of the symptoms can be clearly diagnosed, they can generally be treated well. In case of lack of therapy, however, it can sometimes lead to serious consequences such as a permanent erectile dysfunction, accordingly, should always be consulted for pain in the penis for clarification, a urologist 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.

Pain on the urethra

If the pain in the penis, especially on urination on urethritis (urethritis) may be the cause, which is an inflammation of the urethral mucosa. This is usually 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 rarer cases, however, in a weakened immune system but also viruses, protozoa or fungi can be the trigger, as well as the urethra can be irritated, for example, by a urinary catheter or due to an intolerance to certain contraceptives or lubricants.

Urethritis can in men and women in principle lead to the same symptoms, although these are usually different, because women often feel only an unpleasant feeling when urinating. In men, however, the complaints are usually very pronounced, as they have a significantly longer urethra and the inflammation accordingly affects a larger area. Characteristic is above all a frequent urination, which, however, only difficult and drop by drop and can be very painful. Also, a burning sensation while urinating is possible, it can also itching and burning in the urethra, abdominal pain, slimy-purulent discharge (Fluor urethralis), fever or blood in the urine come.

If no treatment is given, the inflammation can also spread to the testes and epididymis as well as to the prostate or vas deferens, which can lead to further complaints or in more severe cases even to infertility. Accordingly, early treatment is very important, as chronic inflammation of the urethra develops, it can also scarify and harden, creating a urethra (stricture), which are responsible for problems with urination, recurrent cystitis or an abscess in the urethra can.

Penis pain during erection

If the symptoms occur in the penis during erection, they can also be caused by a hematoma or a so-called "penile rupture", which is colloquially often referred to as "penis fracture" or "penile fracture". However, due to the non-existing penile bone, this is not a fracture in the true sense of the word, but a tearing of the erectile tissue of the penis or the surrounding membrane (tunica albuginea). This injury can occur when the limb is erect and it kinks, which is usually during sexual intercourse or, more rarely, during masturbation. In addition, however, a rupture may also be caused when e.g. an erect penis should be hidden and pressed down strongly. In very rare cases, it can also come to sleep during sleep, as the man is lying on his penis during an erection with his entire body weight and this bends as well. If a penile rupture is present, it typically results in bruising, heavy swelling, and severe pain, and tearing of the membrane is usually accompanied by a clearly audible bang and immediate loss of erection.

A bending or curvature of the penis (penis deviation) can also lead to massive pain during erection or sexual intercourse. Of this, about 5% of all men are affected, with a distinction between congenital (congenital) and acquired penile deformities. The former are based on a genetic malformation in the womb, such as unevenly formed cavernous bodies or a shortened urethra (hypospadias). The acquired form, however, often arises as a result of a chronic disease of the two erectile swelling bodies (Induratio penis plastica) or a penis fracture. The symptoms may develop either slowly or with increasing curvature or quite abruptly, but often the penile pain occurs at the beginning of the illness, especially during the erection. The curvature can be quite different, but in most cases, however, shows in an excited state, a curvature up, down or to the side, but is also possible a kind of "kink" in the erected member.

Even a so-called "priapism" comes as a cause in question, what a painful form of erection is called, which lasts more than two hours. Depending on the extent of the disease, a distinction is medically made here between a "low-flow" and a "high-flow" -tripism, whereby the classification results from the extent of the blood flow in the penile erectile tissue. Thus, in the much more common low-flow variant (90% of cases) venous blood from the erectile tissue can not drain, resulting in a permanent erection and from a certain period of time (more than 12 hours) to damage the Schwellkörpergewebes or even (from about 24 hours) can lead to a permanent erectile dysfunction. Due to the congestion of the penis is extremely hardened, the glans blue discolored and soft, also there are no pulsations. Accordingly, it is always a urological emergency, which must be treated as soon as possible medically. The high-flow priapism, however, arises as a result of a strong influx of arterial blood into the erectile tissue, but since the venous drain is not disturbed here, this form of permanent erection is not so dangerous. The pain symptoms here are correspondingly less pronounced than in the low-flow variant, moreover, the limb is still elastic.

In about 50 percent of cases, the permanent erection occurs without apparent cause (idiopathic priapism). For the other half, however, come on various triggers, often, for example, drugs (painkillers, blood pressure, antidepressants, etc.), drugs (amphetamines, marijuana, cocaine) and alcohol abuse responsible. Likewise, neurological diseases (such as multiple sclerosis) or diseases of the blood (leukemia, sickle cell anemia, thalassemia) are possible in addition to injuries in the perineal or genital area, which may arise, for example, when slipping from the saddle to the middle bar of the bicycle or during surgery , In the case of the latter, the treatment of an erectile dysfunction by means of a so-called "swell-body self-injection therapy" (SKAT) is particularly suitable, although the risk here as well is relatively low overall.

Pain on the glans

If the pain occurs in the area of ​​the penis tip, an acne inflammation (balanitis) may be the cause, often involving the foreskin (balanoposthitis). Characteristic here are mainly pain and / or a burning sensation in the area of ​​glans and / or foreskin, redness, swelling and sometimes a very intense itching. In addition, weeping areas or purulent discharge can occur, it is also a chronic inflammation, it often leads to gluing or even to a foreskin narrowing (phimosis). In many cases, it also leads to superficial skin lesions. Depending on the form of the balanitis, these may be manifested, for example, by sudden redness with small nodules and fine, dry scales, as well as by sharply defined reddish spots with a moist superficial, in which small bleedings are often found.

An inflammation of the glans or the foreskin can have many causes, but often it is an infection with pathogens such as fungi (eg, Candida, thrush), parasites (eg trichomonads), viruses (eg, genital herpes, genital warts) or bacteria (eg chlamydia). These can arise on the one hand through sexual contact, but is also possible inadequate genital hygiene, through which accumulates between the glans and inner foreskin, the so-called "smegma", which provides an ideal breeding ground for pathogens. In addition, however, the glans or foreskin may also become inflamed, for example, due to hypersensitivity to drugs or to a contact allergy in which the skin is particularly sensitive to direct contact with a particular substance (e.g., latex, nickel). In addition, a variety of diseases such as psoriasis, diabetes or lichen planus increase the risk of balanitis as well as a weakened immune system (e.g., in HIV) or existing foreskin constriction. In addition, there are favoring 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 penile pain

urethritis
If the pain in the penis caused by a urethritis (urethritis), the therapy is carried out depending on the cause. If bacteria or fungi are the trigger, usually appropriate drugs such as antibiotics or antifungals (antimycotics) are used, in some cases (for example, in chlamydia), it is also necessary to co-treat the life partner. If the cause of the urethritis is not in an infection, must continue to research the trigger, for example, it may be useful to use other hygiene or contraceptive. In case of very severe pain, analgesics can be used in addition to the drug therapy, it is also important to drink a lot and go to 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 avoid prolonged sitting on cold surfaces; if it is a sexually transmitted infection, it is also advisable to abstain from sexual intercourse until complete healing.

penis fracture
If there is a so-called "penile fracture", in any case, medical assistance is required so that those affected should visit the emergency room as soon as possible or, if possible, a urological clinic. In order to avoid long-term consequences such as erectile dysfunction, penile curvature or narrowing of the urethra, surgery is in most cases promptly performed. In mild cases, antiandrogens or sedatives for erections and compressive bandages can be used, in addition, physical protection and cooling is prescribed.

penile curvature
If there is an innate penile curvature or Penisdeviation before, in individual cases, the need for an operative correction is decided, which is due to the potential risks (scarring, bleeding, loss of erection, etc.) usually only in case of discomfort or severe restrictions on sexual intercourse. Even with an acquired curvature come various conservative treatment options in question, such as the intake of drugs, a shock wave therapy or a vacuum pump. However, if there is a very severe curvature and / or the patient suffers from great pain, here also usually an operative intervention is necessary to straighten the bending so far that the complaints are alleviated and sexual contacts are made possible.

priapism
If, for the first time, a painful erection occurs over a period of more than two hours, it will in any case constitute a medical emergency which under no circumstances may be trivialized. Instead, a doctor or hospital should be consulted immediately to clarify the cause and to start treatment immediately if necessary. If a low-flow priapism is present, it can be treated with medicaments to support the blood drain, and a corporal puncture is also possible, through which the blood is sucked out. If this does not help, vasoconstrictor substances can continue to be injected directly into the erectile tissue. If this also does not lead to success, there is the possibility of an operative procedure in which by means of a "shunt connection" between the penile artery and a vein the blood drainage is made possible.

A high-flow priapism, on the other hand, usually has little or no pain at all, and in most cases disappears by itself. Nevertheless, in this case always first a doctor should be consulted to clarify the permanent erection exactly. In the normal case, this is initially followed by the observation of priapism, the erection is a problem for the person concerned, also conservative methods in the form of cooling and compression bandages or the administration of anti-inflammatory drugs can be used.

Balanitis / Posthitis
If inflammation of the glans and / or foreskin is the cause of the pain, the treatment depends primarily on the cause. If, for example, bacteria can be identified as causative agents, an antibiotic in the form of an ointment is usually used in a targeted manner, whereas fungi are administered with certain antifungals (antimycotics), but these are also applied locally to the affected area. If, for example, there is an allergy instead of an infection, cortisone preparations can also be used to inhibit the inflammation. If the inflammation is due to an existing general disease, such as In particular, in the case of chronic inflammation it is also advisable to act early on a foreskin narrowing and to eliminate 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 glans should only be washed off with clean water or cleaned with pure olive oil. It is also advisable to change underwear and towels frequently and to clean in the cooking cycle and to do without washcloths due to a possible contamination completely.

Naturopathy for pain in the limb

If there is inflammation of the lower urinary tract, natural remedies can often provide effective support to relieve the symptoms. Here are a number of home remedies for cystitis into consideration, such as a tea from bearberry leaves, which has an antibacterial effect and can therefore be used sensibly at the first sign of bladder or urethritis such as burning on urination and urinary frequency frequent. A sitz bath can also work wonders in this case. For this example, chamomile tea is placed in an old vessel and placed in the toilet bowl. Then the toilet seat is set normally so that the steam can act directly on the affected areas. Alternatively, a sitz bath can be used in which, for example, a bath with the addition of horsetail is taken for 30 minutes.

In addition, the regular drinking of cranberry cranberry juice has proven in many cases, since it prevents the adhesion of germs to the urethral mucosa and thus can have a positive effect on the course of the disease. Homeopathy also recommends clematis, naphthalene and yohimbinum in cases of inflammation of the urethra or bladder; other classic medicinal herbs in this case include bearberry leaves, stinging nettle and rosehip. (No)

Picture: Klaus Rupp