What Causes Pain In The Penis?

Posted on Sat, 9 Dec 2017

Question: Height- 5'10

Weight- 67KG

Penile Measurement -

Length: 5.9 - 6.0 inches

Girth: 4.9 in the base, 4.5 just below the glans

Dear Doctor,

I am suffering from the below symptoms since June/2014.

I am having penile pain and bend during erection in the underside of the penis. I used to wear tight underwear (when I used to go to gym) and during erection the underwear prevent/restricted the erect penis from going up. I believe this has caused damage to the underside of the penis or the ligament. Also the erected penis barely reach 90 degree angle from the floor.

I feel like something in the underside of the penis is holding the erection. I feel like the underside of penis is non-stretchable or short, that's why its holding the erect penis, thus making the curve. There is a black patch in the underside of my penis, its very smooth/velvety.

I feel the frequent urge to urinate, sometimes very less amount of urine comes out !!

My Questions-

Is it peyronie disease ?

Could it be Chordee ? Sometimes I feel very strange feeling (the underside of penis, the affected area) while urinating.

Does it have anything to do with pelvic floor muscle ? I have problem of incomplete evacuation and I don't feel anything below my belly button. All of these problems- incomplete evacuation, no feeling below belly button, penile pain started at the same time. I also feel mild discomfort in the pelvic area after ejaculation.

Please help.

Thanks

Any other symptoms/ issues: Pain in the underside of erect penis, unable to sustain erection (due to pain, stress), black patch in the underside of the penis, slight penis bend, loss of sexual drive/libido, soft glans.

Hardness of penis during erection: Glans are soft, sides of penis is hard, underside of penis feels strange, its not hard. I feel one muscle/string that is coming out from the base of penis, also highlighted in the images is holding the erection.

Kindly review the attached images.

Please help I am deeply stressed.

Additional Information:

1) Can you palpate hard mass (Plaque) at the site of dent?

No. But this chord is not soft, its thick. On flaccid penis, I don't feel anything.

2) Do you have any difficulty in penetration of Vagina during sexual intercourse with your female partner?

I am virgin.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
It is not chordy

Detailed Answer:
Hello
Thanks for query .

Based on the photographs of your penis both in flaccid and on erection I would like to comment that though there is a curvature of penis on erection it is not definitely due to chordee but is is due to disparity between length an anterior and posterior aspects of a sheath that envelopes erectile bodies called Corpora Cavernosa .The precise cause for this could be due to trivial trauma by wearing a tight inner wares However curvature being less than 10 degree it will not pose any difficulty in having a penetrative intra vaginal sex .

As regards your suspicion about Peyronies disease it can be confirmed only on clinical examination of penis by a qualified Urologist and doing Ultrasound Scanning of penis .

The underside of penis contains urethra which is soft and supple and does not become hard during erection It is only two bodies of Corpora Cavernosa become hard during erection.The purple patch that you feel is a Bulbar Part of Urethra which is thicker than pendular part (Penile)of urethra.

To summarize I would state that you have no structural (Anatomical)abnormality of
penis except a slight curvature which is not going to have any adverse effect on marital life and pose any difficulty in having sexual enjoyment .

All other symptoms that you have are functional due to anxiety and not organic in nature .

Hope I have answered your query ,please feel free to ask if you have more questions,I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (2 hours later)

Thanks doctor for replying. I have few question and would be happy to to get the reply.

1) Why the glans are soft after erection. How will I be able to penetrate ? Is it venous leak ? Can it be fixed ?

2) Why the girth of penis is less in the upper half ?

3) What about the pain I am getting pain during erection? What about the chord (highlighted in the 3rd pic with red arrow) that is coming out of base of penis.. which is also restricting the erection? That chord is not coming out from the middle... it is coming out from only one side.

4) What about the discomfort I feel in the pelvic muscle during erection? I also feel the movement of pelvic muscle during erection.

5) Can this curvature be removed or straightened ?

6) I have never retracted the skin off the penis. I am scared to do that. Is there any problem with that?

Thanks

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
ead answers to your questions ad detaied beow

Detailed Answer:
Hello
Thanks for follow up .

I would answer your queries point to point as detailed below

1) Glans penis is a cap like structure that tighlly covers up both cylinders of erectile tissue called Corpora Cavernosa together .It does not contain erectile tissue hence does not become hard like rest of penis on erection.Since it is tightly snugged with these cylinders it can be easily pushed in to vagina during penetration as vagina is well lubricated after arousal .

2)The girth of penis is always variable due to distribution of blood in erectile tissue .It is distal part of penis that enters into vagina carries importance rather than at base .

3) Since you have not retracted your foreskin there is likely possibility of frenulum being tight causing curvature of penis and stretching of this tight frenulum may be the cause for getting pain during erection .You need to consult qualified Urologist for clinical examination and to rule out Phimosis with thick tight frenulum.

4)The discomfort in pelvic floor can be due to anxiety .

5) The Urologist on clinical finding will be able to explain whether the curvature is due to tight frenulum and if so it can be corrected by a minor surgery of Frenuloplasty.or may need to get circumcised if diagnosed to have Phimosis

6) Try to retract foreskin and see yourself whether it can be retracted freely or not.It is vital important that foreskin should be retracted and cleaned every day while taking bath to maintain good genital hygiene and to prevent accumulation of mucus secreted by glans penis (Smegma)

Hope it will clear out your doubts .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (1 hour later)

Thanks for replying each question in detail. I have few more questions.

1) Please tell me what test(s) do I need to go through to find out (or rule out) any structural (Anatomical) abnormality in - penis and pelvic muscles and any other area that could lead to this problem. I want to scan it all.

Thanks

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Get Ultrasound Scanning of Penis done.

Detailed Answer:
Hello
Thanks for follow up .

A thorough clinical examination by a qualified Urologist and Ultrasound Scanning of Penis will help to detect the cause for your problem precisely .
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (2 days later)

But what about the chord/muscle "that is coming out, a highlighted in the picture".

I can feel that muscle during the erection. I clearly feel like something on the underside of the penis (is it corpus spongiosum?) is restricting the penis erection. thus creating a bend and pain.

I have never retracted foreskin. I feel it would be very painful thing to do...

Answered by Dr. Dr. P. T. Patil (5 hours later)

Brief Answer:
Corpus Spongiosus is no involved in Erection.

Detailed Answer:
Hello
Thanks for follow up .Corpus Spongiosum is a muscle that encircles urethra .The bulge that you notice is a thick muscles and is not involved in process of erection .neither it would restrict erection .

Not retracting a foreskin and cleaning it regularly will lead to accumulation of smegma around glans penis and cause infection .If the foreskin is not retractable completely over glans penis (Phimosis) it may lead to difficulty in penetration of vagina during intercourse .That is the reason I have suggested you to consult qualified General Surgeon or Urologist for clinical examination .That is the only way to confirm or rue out Phimosis .

The real issue can be diagnosed only on clinical examination in person .It is very difficult to ascertain the precise cause or to establish diagnosis on photographs.
Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar