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Superficial phlebitis of the penis; retraction of penis
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Superficial phlebitis of the penis; retraction of penis

I'm a 55 year old male in generally good health.

3 1/2 months ago, before having sex, I noticed that there was a slightly tender cord-like string under the skin of my erect penis, coming from the top middle at the base of the pubic area and extending diagonally over to the left side, where it seemed to disappear into the side of the shaft. There was no specific unusual incident beforehand that I can recall.

5 days later, my regular urologist diagnosed superficial phlebitis, although the palpable cord was no longer evident by then.  Instead there was a more generalized tenderness and an aching/burning sensation on the top right side of the penis. He had no advice as to treatment, and advised that it was rare, not dangerous like other forms of phlebitis, and would eventually go away by itself.

The pain has not gone away and has progressed to being almost continual, usually getting worse as the day goes on.  General pratitioners have recommended warm soaks and NSAIDs, but these have been ineffectual.  Sexual activity sometimes seems to aggravate it, but not immediately - often by the the second day later it may feel somewhat worse, but this is not consistent.  

My questions:

1.  Can you comment on why this may have happened, and what I can expect to happen in the future?

2.  Is there any effective treatment other than waiting/hoping for it to heal by itself?

3.  Should I stop having sex?  No one I've talked to has suggested this - perhaps they assumed I already had.  But erections and sex itself are only slightly uncomfortable.  I would continue to have involuntary erections while sleeping, and I would have to refrain even from any affectionate contact with my life partner to avoid arousal.  I suppose many might feel that sexual activity isn't/shouldn't be very important to a 55-year-old, but for me the desire is still very strong, and until this, the equipment was still working very well.

4.  I'm also experiencing a periodic involuntary retraction of my penis to the point where the head is only partly visible, as reported in this forum last year by a Mr. Higgins. The current inflammation makes this quite uncomfortable.  Is there any relationship?

5.  Would further examinations such as ultrasound, CT scan, etc. be potentially useful?  

6.  Would consultation with a urologist at a university or highly regarded medical center be useful, and how could I find one? (I'm in the Detroit area).  After a recent follow-up visit, I don't feel my regular urologist has anything further to offer me.

I will appreciate your comments.
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To answer your questions:
1) If there was a superficial phlebitis, it may have resolved on its own with conservative therapy.  However, if symptoms continue there is a chance that it may have worsened or another condition is present.

2) Conservative therapy is normally initially recommended.  If the symptoms continue, surgical therapy may be the next step.

3) If the diagnosis is superficial thrombophlebitis, this is normally not a contraindication to sexual activity.

4) I am not aware of this symptom being associated with phlebitis.

5) If the symptoms continue, an ultrasound of the penis would be a helpful study.

6) I would certainly recommend a referral to a urologist - preferably at a major academic medical center.  Calling the urology department for an appointment would be the first step.

These options can be discussed with your personal physician.

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.
kevinmd_
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