lump in penis

I have a condition that in many respects appears to be sclerosing lymphangitis - a vein-like fibrous area under the skin, just below or medial from the glans (glands), on the left side of the penis, going around the circumference.  The left end can move or when I touch it, but on the right end seems to be connected internally.  When I am not erect, it is about 1/2 inch long and 1/16 inch wide.  When I am erect or it is irritated, it is 3/4 inch long and 1/8 inch wide.  When I am having sex, it can fairly easily become painful and/or swollen.  

I first encountered it about 10 years ago, after a period of intense masturbation.  The problem is that it has not gone away, though I have had periods of a month or more with no sexual activity or masturbation.  In the last year, it has gotten worse in that it is longer, more prominent during sexual activity, and more often painful.  Often I feel a soreness or itchiness (under the skin surface) after sexual activity.  Using a condom tends to increase the symptoms.

Recently, I have seen a couple of dermatologists about this, one of whom suggested that it may be sclerosing lymphangitis.  I then went to two urologists, neither of whom was familiar with the term.  All have said that there is no STD or other such problem is present.  

So my question is - are there non-surgical ways of helping this heal?  And if it persists, how do I find urologists who have treated this problem?

Thank you.

[HFHS M.D.-BL]

Dear Jonathan,

Sclerosing lymphangitis is a translucent cordlike lesion that occurs on the shaft of glans (glands) of the penis.  It is usually flesh-colored but may appear slightly red.  It is most commonly associated with vigorous sexual activity, but it is also seen with infections including gonorrhea, syphilis, chlamydia, and herpes.  When biopsy specimens are looked at under the microscope, thrombosed lymphatic vessels are seen.  The thrombosis of these vessels is theorized to be secondary to the local trauma.


Most cases of Sclerosing Lymphangitis of the penis are not painful and remit within several weeks.  Treatment has traditionally consisted of avoidance of vigorous sexual activity until the lesion disappears.  I am not sure how long you initially went without sex once you were given a preliminary diagnosis, but you may have started sexual activity too soon.  Unfortunately a true diagnosis of Sclerosing Lymphangitis would necessitate a biopsy and examination under a microscope, but this is rarely required.  This disorder is usually self-limited (lasting only a few weeks), but in a few rare cases in which there are persistent symptomatic lesions surgery is indicated.  For a rare and confusing case such as yours I would suggest that you seek a urologist at an academic hospital with a Urology residency training program.  


This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).


Sincerely,
HFHS M.D.-BL
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