Penis disorders in a Nut Shell

Disorders of male reproductive system are usually classified as internal or external; depending upon the site of primary involvement of disease process. The external defects of male reproductive system are further classified into; testicular disorders or the penile disorders. It is imperative to mention that both of these organs play a significant role in the maintenance of normal fertility in males. Any acute or chronic disorder of either of the two organs can greatly impair the fertility of males and may culminate in varying degree of physical, psychological and sexual conditions.

Penile disorders

Most frequently reported penile disorders in clinical practice are discussed briefly:

• Priapism
• Balanitis
• Phimosis
• Paraphimosis
• Peyronie’ s disease

1. Priapism

Priapism is a male sexual condition in which the dynamics of the blood to the penile region is compromised/altered, due to which the affected person experiences constant erection (sometimes lasting up to hours). The most irritable part of this disorder is, an inability to relieve erection through orgasm.

Causes of Priapism

Some characteristic causes of priapism include, excessive intake of alcohol, anesthesia, trauma to genital organs, blood disorders, intake of phosphodiesterase inhibitors etc.

Treatment of Priapism

Priapism is a medical emergency. The treatment goal in priapism is to immediately relieve the erection in order to minimize the risk of penile scarring. Following interventions can be adopted:

• Drainage of blood through medications or through invasive methods (like insertion of syringe needle to extract pooled blood).
• Surgery can be performed in some rare cases.

2. Peyronie’s Disease

This condition is characterized by the development of a hard mass, or lump over the penis (also known as peyronie’s disease). In poorly managed cases, long standing inflammation of penis can lead to pain and irritation.

Causes of Peyronie’s disease

Some of the characteristic causes of peyronie’s disease include, hereditary or genetics (if a person have a tendency to develop the hard mass), inflammation of vessels (vasculitis), disorders of connective tissue and other sources of long standing inflammation.

Treatment of Peyronie’s disease

Peyronie’s disease can be managed by:

• Non-surgical treatment: In this type of treatment, the physician generally asks the patient to wait for a year or two; as the plaque can often disappears on its own. If no change in plaque occurs, XIAFLEX can be directly injected in to the mass
• Surgical treatment: surgery is performed by removing the lump or hard mass.

3. Balanitis

It is a condition that is marked by swelling and inflammation along the head of the penis. Another associated condition in which both the foreskin and head of the penis is inflamed is referred to as balanoposthitis. Balanitis patients usually presents with symptoms like disagreeable odor from discharge, itching at the affected site, swelling and redness.

Causes of balanitis

Most frequently reported causes of balanitis include, allergic conditions causing dermatitis, rash due to allergy, fungal infections such as candida albicans, sexually transmitted diseases, diabetes and other inflammatory issues.

Treatment of balanitis

The basic treatment protocol of balanitis is designed after identifying the cause of the disease. Antibiotics and antifungal agents are prescribed according to patent condition. In severe cases of inflammation circumcision is performed which is the removal of foreskin of penis.

4. Phimosis

In this condition the skin of the penis (also called as foreskin) becomes tight, as a result the patient feels pain when pulling back.

Causes of phimosis

This condition is common in infants and neonates. Most common cause of this disorder is infection at the time of birth. Chronic inflammation due to any condition or balanitis can also lead to this disease.

Treatment of phimosis

Several treatment modalities are available to treat this condition such as removal of foreskin of penis (circumcision), prescription of medicine which helps in relaxing the penile foreskin and gently stretching exercises of foreskin.

5. Paraphimosis

It is a complicated cosmetic condition of penis that is characterized by constant retraction of penis and an inability to return to original position.

Causes of Paraphimosis

Several factors can contribute in the development of paraphimosis such as trauma to male genitals, foreskin inflammatory conditions, intense sexual activity etc. If not treated in time, the lack of oxygen can cause gangrene of penile tissue and may culminate in penile amputation.

Treatment of paraphimosis

Basic aim is to reduce the swelling and inflammation of the foreskin. This can be achieved by application of ice over the affected area. In case the swelling is not relieved then either the penis is relaxed through draining the blood through injection or surgical intervention is needed to restore normal anatomical function.

6. Penile cancer

A condition in which the cells of the penis grows abnormally in uncontrolled fashion. The penile caner may also develop from a benign penile tumor.

Causes of penile cancer

Some risk factors that are often reported in the setting of penile cancer are:

• Uncircumcised males are more prone to develop penile cancer
• A positive history of Human papilloma virus infections
• Excessive smoking
• Phimosis

Treatment of penile cancer

Surgical resection of tumor is the most reliable method to address penile cancer. The surgery can be performed by following methods,

• Local excision of cancerous cells
• Cryosurgery (through liquid nitrogen)
• Microsurgery
• Circumcision
• Laser surgery

It is highly recommended to see a healthcare professional if you are experiencing an acute or chronic inflammatory condition of penis. This is mainly because, poorly managed penile conditions can permanently alter the normal functioning of male sexual functions.

References:

1. Rajiah, K., Veettil, S. K., Kumar, S., & Mathew, E. M. (2012). Study on various types of infections related to balanitis in circumcised or uncircumcised male and its causes, symptoms and management. African Journal of Pharmacy and Pharmacology, 6(2), 74-83.

2. Cusini, M., Ramoni, S., Verzì, A. E., & Dinotta, F. (2013). Miscellaneous Disorders. In Atlas of Male Genital Disorders (pp. 165-181). Springer Milan.

3. Bleeker, M. C., Heideman, D. A., Snijders, P. J., Horenblas, S., & Meijer, C. J. (2012). Epidemiology and Etiology of Penile Cancer. In Textbook of Penile Cancer (pp. 1-11). Springer London.