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Penile Glans Biopsy

2 months ago, I had a biopsy done on my penile glans to see if I had psoriasis. Turns out I did have psoriasis, but my problem is the biopsy. It feels like the pain is getting worse. and pretty constant. I went to my dermatologist, and he gave me lidocaine cream. He said my nerves were trying to regenerate and that's why I have the pain. I'm concerned that I may never get over this. I'm afraid the glans is so sensitive, and the biopsy will never fully heal. The cream does nothing to ease the pain. Can someone tell me if this will eventually get better and how long will it take? Is there anything I can do?
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I was referring to the photos at the bottom of the article
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134578 tn?1693250592
I don't want to sound like a Pollyanna about your problem, which of course is terrifically painful in a very sensitive spot. But I've got psoriasis (a spot on my scalp), and I'd be entirely willing to have even a painful biopsy if it would take the whole thing away and it would never come back. It feels constantly raspy and scaly, and looks awful if the wind blows my hair away from it. It's just constantly irritating. I hope your psoriasis is gone for good, and your pain will be worth it in the end.

Good luck with getting more information about a safe painkiller. (As you know, people do get hooked on opioids, so be careful about what your doc prescribes.) Have you tried just the run of the mill pills for pain, like Tylenol or Advil? Sometimes one of those will totally surprise you by working.  
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I’m sorry to hear about your psoriasis. What have you tried on your scalp to help with it? Are used desonide ointment and it cleared the psoriasis up completely. I’m not sure if that would work on your scalp but it’s worth looking into if you haven’t tried it already. I'm definitely not going to go down the opioid road. I don't want to complicate one problem with another. I can handle the pain for the most part. I just want to know if it's going to haunt me forever :(
Probably not forever. Nerves can take a while to heal, but they do finally heal. Thanks for the advice about desonide ointment. Good luck with the different approaches to your pain management. I think those underwear sound like they would help, too.
134578 tn?1693250592
Is that the doctor who did the biopsy? If not, did you speak to that doctor about this?
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No. The nurse practitioner who did the biopsy. Biggest mistake of my life allowing her to do it. I thought she was a doctor. I didn't understand what was happening. She did a shave biopsy.
You might be aiming at the wrong target when you say the painful outcome was due to the biopsy being done by a nurse practitioner. (The best medical care I ever got was when I had a NP as my primary "doctor." I now have a highly recommended MD, and my care has never been more indifferent.)

It sounds like a good idea to see your regular doctor (not the dermatologist) about the pain, since it's supposed to last a couple of weeks, not a couple of months, and your derm has already proven to be unhelpful. (Be cautious -- if he or she recommends painkillers, be careful that they aren't opioids.) I assume that since it was a shave biopsy, there were no stitches? Just trying to think of reasons it would hurt for a longer than it's supposed to.
*a lot longer
Thank you Annie, There were no stiches on a shaved biopsy. When I went to a different dermatologist 2 weeks after the biopsy he said "Why did you let her do that to you? It's going to take forever to heal. I could've told you it was psoriasis just by looking at it."  I'm trying to get an idea about what he meant by forever. I think the problem is the location being on the glans with so many nerves there as compared to any other part of the body. It's really hard to walk without rubbing it.  if I walk and I have to wear a gauze on it most of the time. So I've been basically bed ridden. I've been trying to find anyone on the internet that has been through the same thing but can't seem to find anyone.
Usually a shave biopsy is to check for cancer. Is that what the concern was? It's too bad you didn't find the second dermatologist before you used the services of the first dermatologist.

I'd still check in with your general practice doctor, and see what can be done to promote fast healing, and for pain.
If you aren't squeamish (the article has photos), here's a medical article that discusses someone having a shave biopsy on the head of his penis. It says in passing, "Post-procedure, there may be prolonged pain or discomfort." Unfortunately that is all it says about pain, it doesn't say how prolonged or how it's best treated.


I realize the URL looks funny because it drops the last word of the title, but it's the right URL.

It's an interesting article because as revealed by the biopsy, the person did have a carcinoma, and the shave biopsy was used but still didn't take enough skin to get to its margins. Meaning, this might be the procedure of choice to check a lesion for cancer, because sometimes the biopsy might get enough tissue that it gets to the clean margins that don't have cancer, and that is all that is required. Maybe the second doc could have told you right away it was psoriasis (he says now), but the first doctor's office might have been doing careful work. At least, the article shows that doing this procedure to check on this possibility isn't unheard-of. (And, of course, pain and all, it's still good news for you that it wasn't carcinoma. Good news for the person in the article, too ... he got the tumor removed and as of the time of the article 6 years later, was still cancer-free.)

Sometimes you can get good responses if you write to the author of a medical paper, tell them what's going on for you , and just ask your question (in this case, if they know what to do for pain from this procedure). It's not hard to contact people this day and age of everyone being online ... it might be worth a shot.

Another thing, there are post-surgery underwear for men. My thought would be, try a pair that's shiny, like, nylon or polyester, so it doesn't grab on your other clothes. Here's a link:
https://www.ufmunderwear.com/medical-underwear-for-men/post-surgery.html and I'm sure there are lots of other companies that make them.
Thank you once again for your help on this. I really appreciate the research you did in finding that article. The pictures didn’t make me squeamish because it’s exactly what mine looked like. They were not checking for cancer, however. The nurse practitioner never mention cancer. She said it looked like psoriasis and the only way to know for sure was by doing the biopsy. It all happened so fast. I was in and out of the office in less than 10 minutes. I keep reliving that day so many times in my head. Why didn’t I just say no? I should’ve said let’s treat the psoriasis and see if it goes away.
Anyway, I'm going to contact the person that wrote the article see if I find out what prolonged pain means and ask about treatment. It’s been very scary for me. Because I feel terrified that I will be suffering for this for the rest of my life. I can’t help but worry about that. Especially when there is no progress, and the pain seems to be getting worse rather than better. I wonder if I should go to a urologist. I will make an appointment with my general dr as you suggested too. I’ll look into that underwear as well. I’m willing to try anything at this point.
If the lesion in the photos looked exactly like yours, the second doctor who told you he would have known right away that it was psoriasis is not a reliable source, since the lesion in the photos was skin cancer. Anyway, good luck with the regular doctor, and also trying some tightly-fitting and smooth underwear. You might just need some protection and support.
The lesion in the photo is what the biopsy looked like. The psoriasis was just a small pea size red rash.
I was referring to the photos at the bottom of the article. The post biopsy photos.
Well, hard to say but I can see how you would think your first doctor's office (the nurse practitioner wouldn't have done this alone) jumped the gun, if it didn't look like the guy's "before" picture. Presumably it deleted the psoriasis, but what a cost. I hope your doctor helps you with the pain management.
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