Pain felt in the penis, often termed penodynia, is a symptom that signals an underlying issue, not a diagnosis in itself. This discomfort can range from a dull ache to a sharp, burning sensation, and it may be present constantly or only during specific activities like urination or erection. Because the penis is a complex organ containing the urethra, erectile tissue, and numerous nerve endings, pain can originate from various sources, including infections, physical trauma, or internal disease processes. Any persistent or severe pain warrants prompt medical evaluation to determine the specific cause and initiate appropriate management.
Infectious Causes of Penile Pain
Infections caused by microbial pathogens frequently result in acute penile pain, often accompanied by visible discharge or skin changes. Sexually Transmitted Infections (STIs) are a common source, where bacterial or viral agents directly irritate the delicate tissues of the urethra and glans. Bacterial infections like gonorrhea and chlamydia cause urethritis, leading to a burning sensation during urination (dysuria). They also cause a discharge from the meatus, which may be milky-white, yellow, or greenish.
Genital herpes, a viral STI, causes pain through the formation of small, fluid-filled blisters that rupture and leave behind painful, shallow ulcers on the skin of the penis. These sores appear after an initial tingling or burning sensation and can make contact extremely uncomfortable.
Localized infections are another major cause of discomfort, particularly balanitis, which is the inflammation of the glans penis. This condition is often caused by an overgrowth of yeast, such as Candida albicans, or various bacteria, especially in uncircumcised men due to the warm, moist environment under the foreskin. Balanitis manifests as redness, swelling, and soreness on the head of the penis, sometimes with a thick, foul-smelling discharge. An infection originating in the urethra, known as infectious urethritis, causes a painful burning sensation as urine passes over the inflamed lining.
Acute Injuries and External Irritation
Sudden, acute pain is often the result of direct physical trauma or contact with an irritating substance. A penile “fracture” involves a rupture of the tunica albuginea, the tough fibrous sheath surrounding the erectile tissue. This injury occurs when an erect penis is forcefully bent, resulting in a sudden, sharp pain, a distinct popping sound, and immediate loss of erection, followed by rapid swelling and bruising.
Less severe, but more common, causes involve external mechanical forces or chemical irritants. Skin tears, friction burns, or abrasions can result from vigorous sexual activity or masturbation. A specific cause of acute trauma is the zipper-related penile injury, where the skin becomes entrapped in the zipper mechanism, causing immediate pain and localized swelling.
Irritation and allergic reactions can also induce localized pain. Contact dermatitis may occur from sensitivity to chemical components in personal care products, such as harsh soaps, detergents, or perfumes. Some individuals develop an allergic reaction to latex condoms or spermicides, leading to symptoms like itching, redness, burning, and soreness. These external irritations are distinct from infections because the pain arises from a non-infectious inflammatory response.
Chronic Structural and Inflammatory Conditions
Long-term pain can stem from progressive anatomical changes or persistent inflammation. Peyronie’s disease is characterized by the development of flat scar tissue, or plaque, within the tunica albuginea. This fibrous plaque does not stretch, causing the penis to bend or curve during an erection, which can be intensely painful during the initial, acute phase.
The pain in Peyronie’s disease is due to active inflammation in the forming plaque, and it often subsides over 12 to 18 months, though the curvature may remain. The resulting deformity and inelasticity can also lead to painful intercourse and difficulty maintaining an erection.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a complex condition where pain often radiates to the tip of the penis from the pelvic region. It is defined by chronic pain lasting longer than three months without evidence of a bacterial infection, suggesting a non-infectious inflammatory or neuromuscular origin. The discomfort is typically a persistent ache or burning sensation, sometimes accompanied by painful ejaculation or urinary symptoms.
Another source of lasting pain is the complication following a prolonged erection known as priapism. This urological emergency, particularly the ischemic (low-flow) type, traps oxygen-poor blood in the erectile chambers, leading to localized tissue damage. If not treated quickly, this lack of oxygen can cause scarring and fibrosis of the internal erectile tissue, potentially resulting in chronic pain and lasting erectile dysfunction.
Referred Pain and Systemic Issues
Pain felt in the penis does not always originate from the organ itself, a phenomenon known as referred pain. A common example is pain originating from the urinary tract, such as with kidney stones. As a stone moves down the ureter, the intense pain, which typically begins in the flank or lower back, can travel and be felt acutely at the tip of the penis.
Nerve-related conditions can also cause pain to be mistakenly localized in the penis. Pudendal neuralgia involves irritation or entrapment of the pudendal nerve, a major nerve supplying the pelvic floor and genitals. This condition typically causes a chronic, burning, or shooting pain that is often worse when sitting and can manifest anywhere along the nerve’s path, including the perineum and the penis.
Although rare, systemic conditions like penile cancer can present with localized pain that worsens over time. The most common signs are changes on the skin of the glans or foreskin, such as a persistent sore, a lump, or an area of discoloration. Any new, persistent growth or non-healing ulcer should be medically investigated, as localized pain can be a late-stage symptom.