The penis has three parts: the root, which attaches to the wall of the abdomen; the body, or shaft; and the glans penis, which is the cone-shaped end (head). The opening of the urethra, the tube that transports semen and urine, is at the tip of the glans penis.
The body of the penis is cylindrical in shape and consists of three internal chambers. These chambers are made up of special, sponge-like erectile tissue. This tissue contains thousands of large caverns that fill with blood when the man is sexually aroused. As the penis fills with blood, it becomes rigid and erect, which allows for penetration during sexual intercourse. The skin of the penis is loose and elastic to accommodate changes in penis size during an erection.
Semen, which contains sperm (the male reproductive cells), is expelled through the end of the penis when the man reaches sexual climax (orgasm). Disorders of the penis can affect a man’s sexual functioning and fertility.
What disorders affect the penis?
Some disorders that affect the penis include the following:
Priapism is a persistent, often painful erection that can last from several hours to a few days. The priapism erection is not associated with sexual activity and is not relieved by orgasm. It occurs when blood flows into the penis but is not adequately drained. Common causes of priapism include:
- Alcohol or drug abuse (especially cocaine)
- Antidepressants and blood pressure medications
- Spinal cord problems
- Injury to the genitals
- Penile injection therapy (a treatment for erectile dysfunction)
- Leukemia and sickle cell anemia
Treatment for priapism is important, because a prolonged erection can scar the penis if not treated. The goal of treatment is to relieve the erection and preserve penile function. In most cases, treatment involves draining the blood using a needle placed in the side of the penis. Medications that help shrink blood vessels, which decreases blood flow to the penis, also may be used. In rare cases, surgery may be required to avoid permanent damage to the penis. If the condition is due to sickle cell disease, a blood transfusion may be necessary. Treating any underlying medical condition or substance abuse problem is important to preventing priapism.
Peyronie's disease is a condition in which a plaque, or hard lump, forms on the penis. The plaque may develop on the upper (more common) or lower side of the penis, in the layers that contain erectile tissue. The plaque often begins as a localized area of irritation and swelling (inflammation), and can develop into a hardened scar. The scarring reduces the elasticity of the penis in the area affected.
A report from Italy shows that the main reason forPeyronies disease is taking weekly injections of a medication to treat high blood pressure plus a drug that carries fat into cells.
Usually this is a harmless condition that requires no treatment because the scar disappears, with no treatment, within five years on the average. Impotence associated with Peyronies disease responds well to allavailable treatments for impotence, such as Viagra. Doctors treat Peyronies disease only when it hurts to have an erection or prevents a man from making love.
Surgery option for Peyronies Disease often fails to cure this condition, but it can be cured by injections of verapamil directly into the scar in the penis (5 mg twice a week for 10 weeks) plus a 3-month administration of propionyl-L-carnitine (2 g/day). Check with your doctor.
Balanitis is an inflammation of the skin covering the head of the penis. A similar condition, balanoposthitis, refers to inflammation of the head and the foreskin. Symptoms of balanitis include redness or swelling, itching, rash, pain and a foul-smelling discharge.
Balanitis most often occurs in men and boys who have not been circumcised (had their foreskin surgically removed), and who have poor hygiene. Inflammation can occur if the sensitive skin under the foreskin is not washed regularly, allowing sweat, debris, dead skin and bacteria to collect under the foreskin and cause irritation.
Other causes may include:
- Dermatitis/allergy —
- Infection — Infection with the yeastcandida albicans (thrush) can result in an itchy, spotty rash.
If there is an infection, treatment will include an appropriate antibiotic or antifungal medication. In cases of severe or persistent inflammation, a circumcision may be recommended.
Taking appropriate hygiene measures can help prevent future bouts of balanitis. In addition, it is important to avoid strong soaps or chemicals, especially those known to cause a skin reaction.
Phimosis and paraphimosis
Phimosis is a condition in which the foreskin of the penis is so tight that it cannot be pulled back (retracted) to reveal the head of the penis. Paraphimosis occurs when the foreskin, once retracted, cannot return to its original location.
Paraphimosis is a medical emergency that can cause serious complications if not treated. Paraphimosis may occur after an erection or sexual activity, or as the result of injury to the head of the penis.
Treatment of phimosis may include gentle, manual stretching of the foreskin over a period of time. Sometimes, the foreskin can be loosened with medication applied to the penis. Circumcision, the surgical removal of the foreskin, often is used to treat phimosis.
- Circumcision—Men who are not circumcised at birth have a higher risk for getting cancer of the penis.
- Human papillomavirus (HPV) infection—HPVs are a group of more than 70 types of viruses that can cause warts (papillomas). Certain types of HPVs can infect the reproductive organs and the anal area. These types of HPVs are passed from one person to another during sexual contact.
- Smoking—Smoking exposes the body to many cancer-causing chemicals that affect more than the lungs.
Symptoms of penile cancer include growths or sores on the penis, abnormal discharge from the penis and bleeding. Surgery to remove the cancer is the most common treatment for penile cancer. A doctor may take out the cancer using one of the following operations: