penis pain

[johncortez555666]

Doctor, I developed a small piercing like hole on the underside of the tip of my penis when I was 14 that felt attached to the inside of my penis, I am circumcised, I swear the hole was not there before and was caused by masterbating with hot tub jets overtime, which I used frequently. I am 28 now, after noticing the bump I started getting tons of pain in that direct spot, I went to a urologist, didnt really mention the pain out of embarrassment and we proceeded to have the hole removed surgically, the urologist stupidly removed alot skin, way bigger than the actually hole, however the pain level continued. It wasnt until about three years ago that i went to see another urologist who performed a cystoscopy.

prior to the cystoscopy, he was confident as soon as he entered the bladder, I would feel the pain in the tip of my penis, when the nurse injected some gel into my penis, it hurt, in fact the whole under area is very sensitive alot of the time, I can press down and get pain and sometimes there wont be any pain, but most of the time it hurts when pressure is placed on it, when he performed the cystoscopy nothing hurt until he entered the bladder, which is right when he said it would hurt, in fact the pain was really bad in the tip of my penis, right when the scope entered the bladder

Sometimes when i urinate it comes out in two directions, often painful, but the pain doesnt occur until right when the urine touches the tip, I swear I can feel a dip in the urethra near the bottom tip, same with ejaculating, no problems with erection or orgasm, however i do have a short orgasm...

Also i noticed the development of my penis stop since that moment where I first felt pain, The doctor says there is no way the hot tubs jets over time could have caused the small hole to form or cause any damage.

Should I get a cystoscopy again or any other testing to see if theres internal scarring....he says no,

[johncortez555666]

also is there anyway to do an ultrasound on the penis, maybe theres scarring inside near the head

[johncortez555666]

my urine flow is fine, always been fine, no strain at all

[Rajiv Goel, MD]

Dear johncortez555666,

Thanks for posting your query.

I understand your condition and feel sorry for the state of affairs. Given your history, it is extremely unlikely that you developed a hole while masturbating with water jets. However, I would assume this to be the case as we believe that the patient is often the best judge of his symptoms.

The need for a cystoscopy can be assessed only after an investigation called the uroflowmetry is done. I would also suggest that an ultrasound of the kidney-ureter-bladder region be done. This would not only provide us valuable information about the nature of the problem but would also help us confirm the diagnosis and decide the best treatment option for you.

As I believe that more information helps a physician help a patient better, please let me know about your stream of urine. I would like to know whether you need to strain to pass urine and whether at any point of time, you feel that you have not voided completely and have retained urine inside.

I would suggest that you see a urologist who can perform these investigations and further management can then be decided.

Hope that this information helps and hope that you will get better soon.

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Best Regards,
Dr. Rajiv Goel