Diseases of the penis, also called “penis” are very diverse. Any change in the male penis, at rest or erect, may be a sign of a pathological cause. What are the signs that should lead to consultation?
Definition: what is a disease of the penis?
By diseases of the penis, we mean the pathologies that can touch the penis, the sheath of the penis, the glans, the foreskin. “We must distinguish between diseases of the penis in a flaccid or flaccid state and those of the erect penis” informs Dr. Vincent Hupertan, urologist, andrologist, sexologist.
What are the diseases of the flaccid penis?
Pathologies of the penis at rest are generally skin conditions or dermatoses, inflammatory (eczema, lichen sclero-atrophic psoriasis, etc.), bacterial, viral or fungal infections (balanitis, syphilis which is on the rise, herpes, condyloma due to HPV infection, candidiasis, etc.) describes Dr. Hupertan. The penis may also present a phimosis (congenital or acquired), inability to roll up the foreskin over the glans, or a paraphimosis (a surgical emergency), by squeezing the glans at its base by the foreskin like a ring. We can note the penis frenulum which can break after intercourse.
“Penile cancer is exceptional”
What are the diseases of the erect penis?
Penile diseases can affect the erect penis. There may then be a problem with rigidity, straightness or length. “If erectile dysfunction predominates by far, the Peyronie’s disease is psychologically and physically devastating” says Dr. Hupertan. This pathology is much more common than we thought and little known. “This acquired deformation of the erect penis (kink of the penis) is due to the appearance of a plaque or scar at the level of the corpus cavernosum. This causes a deformity of erect penis because the side presenting the plate is less elastic” he explains. The average age of Peyronie’s disease is 50 years, but it can occur earlier. “Loss of erection length may be linked to diabetes, hormone deficiency, prostate cancer surgery” informs Dr. Hupertan. Finally, diseases of the penis can be urethral pathologies : urethritis, bacterial or viral infections, sexually transmitted infections, urethral strictures… “THE penile cancerlinked to Human Papillomavirus (HPV) is very exceptional” says Dr. Vincent Hupertan. THE priapism which is characterized by an abnormally long and sometimes painful erection. It can sometimes last more than 4 hours.
What are the symptoms of penile disease?
The clinical manifestations will depend on the causative disease.
- They can result in a skin lesion, in the form of a rash or “pimple” in case of sexually transmitted infection (condyloma) or mycosis and associated itching.
- Ulceration should make you think of syphilis or herpes.
- “Warning signs can also be a flowof the whitish depositsurinary discomfort or burning more rarely an odor.”
- Penile disease can also be characterized by inability to retract the glans in case of phimosis, or contraction of the glans at its base by the foreskin in case of paraphimosis.
- Other possible symptoms: a curvature of the erect penis, a loss of rigidity, straightness or length at the time of erection… “When Peyronie’s disease plaque appears on the corpora cavernosa, the penis may be painful” specifies Dr Hupertan.
What examinations to know if we have a disease of the penis?
“The diagnosis of penile diseases is essentially clinical” inform this specialist. The doctor first observes the physical signs while questioning the patient about their lifestyle, habits and family history without forgetting their sexuality and risky behavior. If he suspects a sexually transmitted infection, a removal of the lesion can be achieved. “If flat HPV lesions are suspected, a peniscopy (examination with a colposcope or magnifying glass of the genitals and perianal region) with application of diluted acetic acid can be performed” says Dr. Hupertan. “A ultrasound can be carried out if Peyronie’s disease is suspected, or more rarely an MRI or a Doppler ultrasound to see the quality of the arteries in the event of erectile dysfunction” he informs.
What are the treatments for penile disease?
Treatments depend on the cause of the disease affecting the penis: the treatment of the infection, or the mechanism causing the symptoms.
► Infections, condyloma; eczema: “Bacterial or fungal infections are treated with anti-infectives, anti-fungals, condyloma by laser, cryotherapy or application of cream based on Imiquimod (Aldara). Dermatological diseases such as eczema, psoriasis or lichen can be treated with the application of topical corticosteroids” says Dr. Hupertan.
► Phimosis: Phimosis gives rise to surgical intervention: foreskin plasty (posthoplasty) or posthectomy (medical circumcision).
► Erectile dysfunction are treated with erection medications, sometimes surgery.
► As for Peyronie’s disease, there has been little effective treatment until now. “For two years, a revolutionary treatment has been available in France, says Professor Hupertan. It is a collagenase, an enzyme, which, when injected into the plaque, will partially dissolve it. These injections allow you to recover length and have a little less inclination. But it is an expensive treatment and few urologists are accredited to do it.” he elaborates. Another recent treatment, using low intensity shock waves, has a pain-relieving effect and stabilizes the plaque, which helps improve the deformation. Surgical correction treatment can be undertaken to straighten the erect penis.
Thanks to Dr. Vincent Hupertan, urologist, andrologist, sexologist, member of the AFU Andrology and Sexual Medicine Committee.