Penis overview

The penis is a sex organ that is part of the male reproductive system. Since the urethra runs through the penis, it also functions in conjunction with the urinary system. The penis has three primary functions: reproduction, sexuality and urination.

The Penis – Medical Conditions

Urologists commonly see patients who are experiencing health concerns associated with the penis. Some of these conditions include:

• Urethral obstruction (stricture)
• Curvature of the penis (Peyronie’s Disease)
• Infection
• Erectile Dysfunction
• Phimosis
• Priapism
• Penile Cancer

Urethral obstruction (or stricture) is the inability to urinate due to a blockage. The blockage may be partial or complete. Obstruction symptoms can include: incomplete emptying, a weak stream of urine, dribbling, or straining to urinate. Obstructions can be caused by a traumatic injury, an infection, catheter use, or physical abnormalities, among others.

Peyronie’s disease is a plaque formation in the penis that occurs outside the urethra. This plaque build-up causes the penis to curve making it somewhat shorter during erection. A slight curvature may not affect sexual function, however, some curvatures make it impossible to have intercourse. Peyronie’s disease can be treated either medically or surgically depending on the curvature.

Infections can create scar tissue in the urethra and resulting in urinary blockage. Depending on the infection, it can be treated with antibiotics. However, abscesses and scar tissue may require surgery. Infections can include sexually transmitted diseases (STD) or urinary tract infections.

Phimosis. The foreskin of an uncircumcised penis is normally very elastic and can be retracted easily to reveal the glans (end of the penis). Phimosis occurs when the foreskin cannot be pulled back to reveal the glans. When retraction of the foreskin is not possible, the glans underneath cannot be cleaned properly and may become infected. If the foreskin becomes infected, it can also shrink making urination difficult. During erections, the glans should automatically show itself. If that is not possible, erection may be painful and require medical attention.

Erectile Dysfunction (ED) can result from psychological issues, neurologic disease, post-surgical changes, hormonal abnormalities, medications, lifestyle choices, and diseases of the blood vessels. In reality, many physical and medical disorders can impact erectile function. Narrowing of the vessels that supply blood to the penis, can decrease blood flow causing weakness or absence of an erection. Likewise, nerves that control erections may not function properly leading to ED. There are many options for treating erectile dysfunction including medications, injections, vacuum devices, and penile implants.

Priapism is a prolonged and painful erection that may last from a few hours to several days. This erection is not associated with erotic thoughts or sexual activity, but rather medication or systemic disease. Penile injections used to treat some forms of impotence may cause priapism. Some psychiatric medications, certain forms of leukemia, and sickle cell anemia may also cause priapism. Medical help should be sought immediately if an erection continues for longer than four hours to avoid permanent damage.

Penile cancer is somewhat rare. According to the American Cancer Society, it affects about 1 in 100,000 American men each year – under 1% of all cancers annually. While rare, when a tumor develops, it may appear as a “wart” on the glans or the foreskin. Unfortunately, it may be overlooked because penile tumors tend to grow and spread relatively slowly. It is often found in elderly men who also have a narrowing of the foreskin, or phimosis, thus hiding the underlying cancer. This cancer can sometimes be treated with radiation, but most often is treated surgically.

When penile conditions occur, a urologist will perform an initial evaluation of the patient. The evaluation may include:

• A physical exam
• Medical and family history
• Lab tests – may include urinalysis and/or blood screening
• Ultrasound
• Neurologic testing
• If blockage is suspected, a visual inspection of the urethra will be performed with a scope
• Additional testing is utilized if cancer is suspected

If you are experiencing penile concerns, contact our office to schedule an appointment with one of our urologists.