Types of Penis Disorders

There are many different types of penis disorders.

Penis disorders may affect men’s sexual life, fertility and overall well-being. Some are minor and don’t cause many issues. However, some may lead to serious emergencies. The most common penis disorders are as follows

• Balanitis (swelling, redness and infection of the head of the penis seen in uncircumcised men)
• Phimosis (tight foreskin of the penis)
• Paraphimosis (the foreskin once retracted gets stuck behind the head and cannot return)
• Priapism (a persistent, often painful erection that does not go away or lasts for more than four hours)
• Peyronie’s disease (bending of the penis during an erection due to a hard lump or plaque)
• Cancer of the penis 
• Erectile dysfunction (difficult to get or keep an erection)

There are other problems too such as premature or delayed release of semen (ejaculation), semen entering the bladder instead of emerging through the penis (retrograde ejaculation), penile fracture, birth defects in which the urinary opening is not located at the tip of the penis (hypospadias), etc.

Balanitis

• Hypersensitivity to (allergy) certain products or chemicals (soaps, detergents, perfumes and spermicides)
• Sexually transmitted infections (STIs) such as gonorrhea (clap), herpes (shingles) and syphilis (chancre)
• Diabetes
• Poor personal grooming

Phimosis and paraphimosis

• Birth defect
• Infection
• Scar tissue formation after injury
• Posthitis (a condition that leads to scarring and tightening of the foreskin)
• Poor personal grooming habits

Priapism

• Drug abuse
• Certain medications (examples antidepressants or blood pressure medicines) 
• Spine disorders 
• Injury to the groin area 
• Anesthesia 
• Administration of injections in the penis (usually given for erectile dysfunction) 
• Blood diseases such as leukemia (blood cancer) and anemia (low iron in the blood)

Peyronie’s disease

• Injury during sexual activity

Ejaculation disorders and erectile dysfunction

• Anxiety, stress and depression during sex
• Other psychological factors such as stress and emotional or relationship conflicts
• Certain drugs such as antidepressants may lead to spine/back nerve or bladder (urine pouch) nerve damage
• Long-term health issues such as diabetes and heart disease
• Medication side effects
• Drinking alcohol
• Surgery
• Unhealthy habits
• Lack of exercise

There are high chances of penile cancer in men who

• Have not been circumcised
• Have human papillomavirus (HPV) infection 
• Smoke
• Have phimosis (rigid, unretractable foreskin of the penis)
• Have unhealthy unhygienic habits
• Are receiving psoriasis treatment medications 
• Are in constant exposure to ultraviolet light
• Are over the age of 50 years old

Many of these conditions can be treated and can even be prevented with good hygiene. However, some are a medical emergency.

See your urologist if you have

• Pain or tenderness in your penis
• Unhealthy discharges
• Itchy rash, blisters, sores or small red bumps on your penis
• Blood in your urine or semen
• An erection that lasts for four hours or more
• Foreskin that is too tight

Balanitis: Appropriate antibiotics or antifungal medications will help clear the infection. For diabetics, good control over sugar levels is a must. For severe, recurrent infections, a circumcision may be suggested. Avoiding chemicals and maintaining good hygienic measures can help prevent repeated occurrences.

Phimosis: This requires immediate medical attention and can be treated by 

• Gently stretching the foreskin of the penis over a period of time. 
• Taking some medications such as steroid ointments that are applied to loosen the foreskin. 
• Separating the foreskin from the glans (rounded part of the penis) and preserving it which is less traumatic.
• Performing circumcision in some children completely removing the foreskin surgically. 

Paraphimosis: This may occur after an erection during sexual activity. It can cause pain, swelling and impaired blood supply to the penis requiring immediate treatment including

• Applying ice to help reduce the swelling or applying pressure on the glans (rounded part of the penis) may force out blood flow. 
• If this does not work, then medications are injected into the penis to help drain the penis and reduce swelling. 
• In severe cases, circumcision (cutting of the foreskin) may relieve the erection.

If not treated immediately, it may lead to serious complications such as gangrene (death of the tissue) and may require amputation (removal of the penis).

Priapism: If erections are not rigid or painful, then urgent treatment may not be required. However, ischemic priapism can be an emergency. Immediate treatment is required to avoid permanent damage to the penis. It can be treated by draining the blood by using a needle inserted into the side of the penis and medications to shrink the blood vessels to reduce the blood flow to the penis. Sometimes, it may require surgery to avoid permanent damage or blood transfusion in case of anemia. Proper treatment of medical conditions or substance abuse may prevent priapism.

Peyronie’s disease: This does not need any treatment unless a man wants to have penetrative sex. 

• Nonsurgical treatment
  • Injecting medications directly into the plaque can soften the affected tissue and correct the bending.
• Surgical treatment
  • Removing the plaque and placing new tissues treats the condition.
  • Removing or pinching the side tissues of the penis can straighten the penis.
  • Penile implants may be required for achieving or maintaining normal erections.

Erectile dysfunction and ejaculation disorders can be treated with

• Oral medications
• Kegel exercises
• Penile implants
• Penis pumps
• Testosterone (male hormone) therapy

Penile cancer: This is rare and highly curable. Surgery may be required for removal of the cancer. It is performed by 

• Using wide local excision
• By removing only the foreskin
• Using a microscope
• Using laser surgery

In some cases, the entire penis or part of the penis may need  to be removed along with the lymph glands. Radiation and chemotherapy will be also used to kill cancer cells.