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Urology (Expert Forum)
Possible penile dysplasia or cancer?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Possible penile dysplasia or cancer?
by henry2, Oct 18, 2005 12:00AM
Hi Dr:
I am a 44 year old male. About 10 years ago my wife was diagnosed and treated for cervical dysplasia. At the same time I had genital warts on the shaft of my penis. I know the HPV virus that causes dysplasia is different from the ones that cause warts, so I assume, since we have sex on a regular basis, that we both carry both strains of the virus. I am not sure when it happened, but anywhere from 6 months to 1 1/2 years ago (i kind of forgot about it, so don't remember when it happened)I noticed a small "dent" or "divot" like area on the left side of my penis head, not far from the corona. I have since learned the correct term would be an ulcer, but it is dry and painless. It looked like the skin in the ulcer was skin colored to slightly pink. I figured it was an injury from oral sex (i.e. teeth tearing away part of the skin"), and hadnt thought about it until now. I recently went to a dermatologist who looked and treated another red spot on my penis head (dermatitis)that was on the corona, and a little bit on the shaft. Dermatop was the treatment used. However, I forgot to ask him about the ulcer which was on the opposite side, and he never investigated the whole head. I went to a Urologist for urethra pain, and am currently on levaquin for mild prostitis (14 day regime of 500mg). While I was there, I showed him the ulcer, and he wasnt sure what it was, but said to watch it. He said he didnt notice any warts in or around it, but it is my understanding that the HPV virus that causes dysplasia would not have a wart present anyway. I am circumsized, and think I have been since birth, or at least since 3 years of age. He told me that circumsized men NEVER get penis cancer, in fact, he had never heard of a circumsized man ever getting penis cancer. From that statement, I knew immediately that he was uninformed (he was fairly young, in his 30's, and has probably never seen a case of penile cancer in his practice). I realize that circumsized men getting penile cancer is very, very rare, but it still makes up about 10% of penile cancers, and my smoking and HPV may even up the odds. In any case, last week i started putting dermatop on the ulcer, hoping that it was just dermatitis. After 8 days, I have seen no changes, in fact, I sometimes get some slight pain at the sight, and if anything, it appears a little larger. I will continue for a few more weeks and see if it helps, but what are your thoughts on this condition?
I am a 44 year old male. About 10 years ago my wife was diagnosed and treated for cervical dysplasia. At the same time I had genital warts on the shaft of my penis. I know the HPV virus that causes dysplasia is different from the ones that cause warts, so I assume, since we have sex on a regular basis, that we both carry both strains of the virus. I am not sure when it happened, but anywhere from 6 months to 1 1/2 years ago (i kind of forgot about it, so don't remember when it happened)I noticed a small "dent" or "divot" like area on the left side of my penis head, not far from the corona. I have since learned the correct term would be an ulcer, but it is dry and painless. It looked like the skin in the ulcer was skin colored to slightly pink. I figured it was an injury from oral sex (i.e. teeth tearing away part of the skin"), and hadnt thought about it until now. I recently went to a dermatologist who looked and treated another red spot on my penis head (dermatitis)that was on the corona, and a little bit on the shaft. Dermatop was the treatment used. However, I forgot to ask him about the ulcer which was on the opposite side, and he never investigated the whole head. I went to a Urologist for urethra pain, and am currently on levaquin for mild prostitis (14 day regime of 500mg). While I was there, I showed him the ulcer, and he wasnt sure what it was, but said to watch it. He said he didnt notice any warts in or around it, but it is my understanding that the HPV virus that causes dysplasia would not have a wart present anyway. I am circumsized, and think I have been since birth, or at least since 3 years of age. He told me that circumsized men NEVER get penis cancer, in fact, he had never heard of a circumsized man ever getting penis cancer. From that statement, I knew immediately that he was uninformed (he was fairly young, in his 30's, and has probably never seen a case of penile cancer in his practice). I realize that circumsized men getting penile cancer is very, very rare, but it still makes up about 10% of penile cancers, and my smoking and HPV may even up the odds. In any case, last week i started putting dermatop on the ulcer, hoping that it was just dermatitis. After 8 days, I have seen no changes, in fact, I sometimes get some slight pain at the sight, and if anything, it appears a little larger. I will continue for a few more weeks and see if it helps, but what are your thoughts on this condition?
Doctor's Answer
by Kevin Pho, MD, Oct 19, 2005 12:00AM
, Oct 19, 2005 12:00AM
You are correct in that HPV is strongly associated with penile cancer.
That being said, it will be difficult to say what is causing the lesion without seeing it myself.
Infection such as herpes or genital warts certainly are possible. If there is continuing concern about penile cancer, a biopsy of the affected area would be most comprehensive a definitive test for diagnosis. This can be considered if cancer is suspected.
Regarding the urethral pain, the antibiotic you are on is an appropriate choice. If it continues, you can consider a transrectal ultrasound to evaluate the possibility of a prostate abscess - which antibiotics won't help.
These options can be discussed with your personal physician or urologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
That being said, it will be difficult to say what is causing the lesion without seeing it myself.
Infection such as herpes or genital warts certainly are possible. If there is continuing concern about penile cancer, a biopsy of the affected area would be most comprehensive a definitive test for diagnosis. This can be considered if cancer is suspected.
Regarding the urethral pain, the antibiotic you are on is an appropriate choice. If it continues, you can consider a transrectal ultrasound to evaluate the possibility of a prostate abscess - which antibiotics won't help.
These options can be discussed with your personal physician or urologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
Member Comments
by henry2, Oct 20, 2005 12:00AM
To: Penile Cancer
0
