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Urology (Expert Forum)
Ongoing Penis Pain/Discomfort
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Ongoing Penis Pain/Discomfort
by HappyFlappy, Oct 16, 2004 12:00AM
Hi,
Thank you for your helpful service. I have learned a lot through this site while researching my own health. Here's the situation.
I am a 31 single male.
I have a sensitive, sore penis, more like a chronic nagging uncomfortable feeling on the foreskin area. It is most acute below the head. It is about a 1/2 cm in area. It has been going on for 1 1/2 years.
I have HPV and been treated for warts on penis. And a slight case of psoriasis, only on the buttocks.
My dermatologist diagnosed this sore area as psoriasis in June 03. We went through a bunch of creams, tar, psoriasis remedies, none of which aleviated the pain. Eventually the best relief came from vaseline and wrapping the penis in saran wrap.Provided protection from clothing and prevented friction. Pain has improved as of 10/04. Because the pain was alleviate a little and skin condition improved, we both thought progress was being made. However, it is not gone.
My 1st derm says it could be slight nerve damage. I saw a 2nd derm who said maybe. The 2 derms agreed that I should numb the penis with topical anasthetics lidocaine (LX4) and pramosome. The idea was to reprogram the nerve if it had been damaged slightly (perhaps due to cryotherapy freezing of HPV conylomas off by the 1st derm). I have been doing this for a month now and although the soreness has improved since it first began in 03, my penis still feels v. abnormal.
Both derms agree there is no evidence of STD infection. I have no discharge, no urine discomfort, no pain on ejaculation, in otherwise great health. I do not have pain in my butt or prostate area. My penis only hurts in this one area.
However, my erections take a lot of work to maintain, are not as hard as they were, I am not getting nocturnal erections as far as I know and I do not wake up with erections any more.
I do masturbate a lot. It reduces the pain. When I masturbate I make my penis fully erect but it does not happen spontaneously. My ejaculation is not as powerful as it was. It just dribles mostly. I am constantly feeling this penis pain.
I have an appointment with my GP on Friday & Derm 2 on Thurs. I am assuming all std test will be negative (If not, easy answer). I was told by derm 1 to see a neurologist (appt. made in a month) to see if if he knows what this pain is about.
My questions:
1) If this is nerve damage that occured in June 03, what is the best way to get the nerves to heal? Have you heard of this before? If it does not heal, will my penis become numb? (Please so no.)
If its not nerve damage:
2) Could this be a bacterial infection?
3) Does it sound like prostatitis or edydimitis?
4) I do have HPV, could this be an ingrown wart affecting a nerve?
5) Could it be chlamydia or gonnorhea? (I don't have discharge? If so, had it for over a year.)
6) Is masturbation helpful to regenerating full function if it is nerve damage?
What else should I do?
Thanks for your help!
Thank you for your helpful service. I have learned a lot through this site while researching my own health. Here's the situation.
I am a 31 single male.
I have a sensitive, sore penis, more like a chronic nagging uncomfortable feeling on the foreskin area. It is most acute below the head. It is about a 1/2 cm in area. It has been going on for 1 1/2 years.
I have HPV and been treated for warts on penis. And a slight case of psoriasis, only on the buttocks.
My dermatologist diagnosed this sore area as psoriasis in June 03. We went through a bunch of creams, tar, psoriasis remedies, none of which aleviated the pain. Eventually the best relief came from vaseline and wrapping the penis in saran wrap.Provided protection from clothing and prevented friction. Pain has improved as of 10/04. Because the pain was alleviate a little and skin condition improved, we both thought progress was being made. However, it is not gone.
My 1st derm says it could be slight nerve damage. I saw a 2nd derm who said maybe. The 2 derms agreed that I should numb the penis with topical anasthetics lidocaine (LX4) and pramosome. The idea was to reprogram the nerve if it had been damaged slightly (perhaps due to cryotherapy freezing of HPV conylomas off by the 1st derm). I have been doing this for a month now and although the soreness has improved since it first began in 03, my penis still feels v. abnormal.
Both derms agree there is no evidence of STD infection. I have no discharge, no urine discomfort, no pain on ejaculation, in otherwise great health. I do not have pain in my butt or prostate area. My penis only hurts in this one area.
However, my erections take a lot of work to maintain, are not as hard as they were, I am not getting nocturnal erections as far as I know and I do not wake up with erections any more.
I do masturbate a lot. It reduces the pain. When I masturbate I make my penis fully erect but it does not happen spontaneously. My ejaculation is not as powerful as it was. It just dribles mostly. I am constantly feeling this penis pain.
I have an appointment with my GP on Friday & Derm 2 on Thurs. I am assuming all std test will be negative (If not, easy answer). I was told by derm 1 to see a neurologist (appt. made in a month) to see if if he knows what this pain is about.
My questions:
1) If this is nerve damage that occured in June 03, what is the best way to get the nerves to heal? Have you heard of this before? If it does not heal, will my penis become numb? (Please so no.)
If its not nerve damage:
2) Could this be a bacterial infection?
3) Does it sound like prostatitis or edydimitis?
4) I do have HPV, could this be an ingrown wart affecting a nerve?
5) Could it be chlamydia or gonnorhea? (I don't have discharge? If so, had it for over a year.)
6) Is masturbation helpful to regenerating full function if it is nerve damage?
What else should I do?
Thanks for your help!
Doctor's Answer
by Kevin Pho, MD, Oct 18, 2004 12:00AM
, Oct 18, 2004 12:00AM
To answer your questions:
1) If there is nerve damage, there is no "best" way that the nerves can heal. I am not aware of studies suggesting a specific method to facilitate healing. A neurology referral can be considered if what you are doing isn't working.
2) Although there are no clinical symptoms for infection, you can consider a prostate exam and urinalysis for more objective data.
3) It is possible - the tests mentioned above, in addition to gonorrhea or chlamydia, can be considered to rule these possibilities out.
4) It is possible that this scenario may be causing the irritation.
5) (see above) - the test is a simple urine test.
6) Masturbation should not be associated with the degree of damage nor repair. You may want to discuss this with a neurology referral.
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.
Medical Weblog:
kevinmd_b
1) If there is nerve damage, there is no "best" way that the nerves can heal. I am not aware of studies suggesting a specific method to facilitate healing. A neurology referral can be considered if what you are doing isn't working.
2) Although there are no clinical symptoms for infection, you can consider a prostate exam and urinalysis for more objective data.
3) It is possible - the tests mentioned above, in addition to gonorrhea or chlamydia, can be considered to rule these possibilities out.
4) It is possible that this scenario may be causing the irritation.
5) (see above) - the test is a simple urine test.
6) Masturbation should not be associated with the degree of damage nor repair. You may want to discuss this with a neurology referral.
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.
Medical Weblog:
kevinmd_b
Member Comments
by shortyb2000, Nov 15, 2004 12:00AM
To: Urology - General
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