Penile pain is discomfort ranging from mild to severe, affecting the internal or external structures of the penis. Understanding its potential causes is important for proper management, as while some instances may be temporary, others can indicate a more serious underlying health issue.
Understanding Infectious and Inflammatory Causes
Infections and inflammatory processes frequently contribute to penile pain, often with other noticeable symptoms. These conditions arise when bacteria, viruses, or fungi affect penile tissues or surrounding structures.
Urinary tract infections (UTIs) can cause penile discomfort when bacteria, typically from the bowel, ascend the urethra. Symptoms often include pain or a burning sensation during urination and a frequent urge to urinate. Sexually transmitted infections (STIs) are another common infectious cause, with conditions like gonorrhea, chlamydia, herpes, and syphilis leading to pain. These STIs may also manifest as discharge from the penis, sores, blisters, or lesions.
Balanitis, an inflammation of the glans (head of the penis), commonly results from poor hygiene, fungal infections such as Candida, or allergic reactions. This condition typically presents with redness, swelling, itching, and pain on the glans, sometimes accompanied by a thick discharge or foul smell. Urethritis, which is inflammation of the urethra, can be infectious (often linked to STIs) or non-infectious. It causes pain during urination, an increased urge to urinate, and sometimes penile discharge.
Pain from Physical Injury and Trauma
Direct physical impact or trauma to the penis can lead to immediate and often severe pain. The penis, though flexible when flaccid, is vulnerable to injury, especially when erect.
Blunt force trauma, such as from falls, sports accidents, or direct impacts, can cause bruising, swelling, and pain. A more severe and urgent injury is a “penile fracture,” which is not a bone fracture but a rupture of the tunica albuginea, the fibrous sheath surrounding the erectile bodies. This injury usually occurs during vigorous sexual activity when the erect penis bends sharply, often accompanied by a sudden popping sound, immediate loss of erection, severe pain, and rapid swelling and bruising, sometimes resembling an “eggplant deformity.”
Zipper injuries, more common in children but also occurring in adults, involve the skin of the penis or foreskin getting caught in a zipper. This can cause localized pinching, pain, swelling, and bruising. Another traumatic injury involves constriction, where objects like rings or hair tourniquets encircle the penis. Such constriction can impede blood flow, leading to rapid swelling, severe pain, and potentially tissue damage if not promptly relieved.
Structural and Neurological Conditions
Beyond infections and acute injuries, certain structural changes within the penis or issues affecting its nerves can cause pain. These conditions may develop over time and significantly impact penile function and comfort.
Peyronie’s disease involves the development of fibrous scar tissue, known as plaque, inside the penis. This plaque can lead to painful erections, curvature of the penis, and sometimes a reduction in length or girth. Pain can occur even when the penis is not erect, particularly during the acute phase.
Priapism is a prolonged, often painful erection not related to sexual arousal, typically lasting four hours or more. This condition is a medical emergency because trapped blood in the penis can become deprived of oxygen, potentially leading to permanent tissue damage. Pain associated with priapism often worsens over time.
Nerve entrapment or damage can result in chronic penile pain. Conditions such as pudendal neuralgia, where the pudendal nerve is irritated or compressed, can cause burning, tingling, or shooting pain in the penis, perineum, or genital area. This neuropathic pain can be debilitating and may worsen with activities like sitting. Pain felt in the penis can also be referred pain, originating from other areas of the body. Conditions like prostatitis (inflammation of the prostate gland), epididymitis (inflammation of the epididymis), kidney stones, bladder issues, or chronic pelvic pain syndrome can manifest as discomfort in the penile region.
When to Seek Professional Medical Advice
Understanding when to seek medical attention for penile pain is important for timely diagnosis and management. While some causes might be minor, others necessitate prompt professional evaluation to prevent complications.
Immediate medical attention is necessary for certain red flag symptoms. These include severe acute pain, sudden onset of significant swelling, or a “popping” sound heard during an erection (which may indicate a penile fracture). A prolonged, painful erection lasting four hours or more (priapism) also requires emergency care to prevent permanent damage. Other urgent signs include difficulty urinating, fever accompanied by penile pain, or deep lacerations.
For less immediate but persistent concerns, a medical consultation is advisable. This includes pain that does not resolve, pain accompanied by discharge, sores, rashes, or unusual lumps on the penis. Any pain experienced during urination, or discomfort that interferes with daily activities or sexual function, also warrants evaluation by a healthcare professional.