Pain in the penis (penilegia) demands attention due to the high sensitivity and complex network of nerves and tissues in the area. The sensation can manifest as a dull ache, a sharp sting, or a persistent burning feeling. Because the penis is connected to the urinary and reproductive systems, discomfort may originate from the organ itself or be referred from nearby structures like the bladder or prostate. Understanding the source requires considering a wide spectrum of causes, ranging from minor irritations to profound underlying medical conditions.
Acute Injury and External Irritation
Physical trauma is a common source of immediate penile pain, often resulting from blunt force or friction. A penile fracture involves a tear in the tunica albuginea, the fibrous sheath surrounding the erectile tissue. This occurs when the erect organ is bent suddenly during vigorous activity. The injury typically presents with a distinct popping sound, sudden pain, rapid swelling, and bruising. Less severe injuries include a zipper catching the skin or friction burns from clothing or sexual activity.
External irritants can also trigger a painful inflammatory response, such as contact dermatitis from chemicals in soaps, lubricants, or latex. Balanitis, inflammation of the glans, can be non-infectious when poor hygiene allows irritants or smegma to accumulate under the foreskin. This inflammation causes localized pain, swelling, and sometimes discharge. While severe trauma requires prompt medical intervention, most acute pain resolves quickly once the source of irritation is removed.
Infections and Inflammation
Infectious agents frequently cause penile pain by triggering inflammation within the urethra and surrounding tissues. Urethritis, inflammation of the urethra, is characterized by a sharp, burning pain during urination (dysuria). Pathogens like gonorrhea and chlamydia colonize the urethral lining, causing swelling, nerve irritation, painful sensation, and often a visible discharge.
Bacterial Urinary Tract Infections (UTIs) can also cause inflammation extending into the penis. Yeast infections, primarily caused by Candida albicans, may result in balanitis, presenting with intense itching, a thick, white discharge, and surface pain. The inflammation from these infections can make the organ tender to the touch. If the infection spreads, such as with herpes simplex virus, it can cause clusters of small, painful blisters or ulcers on the skin.
Underlying Anatomical Conditions
Chronic or structural issues can lead to persistent or recurring pain that is often mechanical or deeply seated. Peyronie’s disease involves the formation of non-elastic scar tissue (plaque) within the tunica albuginea. This plaque prevents the tissue from expanding fully during an erection, causing the penis to bend. This results in pain during sexual activity or erection, typically most severe in the early, inflammatory phase of the disease.
Priapism is a prolonged, painful erection lasting more than four hours without sexual stimulation. This sustained erection is painful because stagnant, trapped blood leads to oxygen deprivation (ischemia), damaging the erectile tissue. If not treated quickly, this can lead to permanent scarring and erectile dysfunction.
Pain can also be referred from structures elsewhere in the pelvic region. Prostatitis, inflammation of the prostate gland, often causes a dull, constant ache in the pelvic floor or base of the penis. Referred pain also occurs with the passing of a kidney stone, perceived in the genital area as the stone nears the bladder. In rare instances, persistent pain accompanied by a non-healing sore, lump, or unusual discharge may signal penile cancer, which causes pain by invading surrounding nerves and tissues.
Signs That Require Immediate Medical Care
Certain symptoms accompanying penile pain signal a potentially serious medical emergency requiring immediate attention to prevent permanent damage.
Immediate medical care is necessary for:
- Any erection lasting four hours or longer (Priapism), which risks irreversible tissue damage.
- Sudden, excruciating pain following trauma, especially with a snapping sound or rapid bruising, suggesting a penile fracture that requires urgent surgical repair.
- A complete inability to urinate, indicating acute urinary retention.
- Pain accompanied by systemic signs such as a high fever, chills, or widespread body aches, signaling a severe infection.
- Significant, rapid swelling of the entire organ.
- The appearance of deep, open lacerations.
These symptoms warrant immediate assessment at an emergency department.