Penile Pain Differential Diagnosis
The following is a differential diagnosis for penile pain, categorized for clarity and emphasis on critical conditions.
Single Most Likely Diagnosis
- Phimosis or Paraphimosis: This condition involves the inability to retract the foreskin (phimosis) or its retraction behind the glans penis (paraphimosis), leading to pain, swelling, and potentially severe complications if not addressed promptly. It's a common issue that can cause significant penile pain.
Other Likely Diagnoses
- Balanitis: Inflammation of the glans penis, often due to infection or poor hygiene, which can cause pain, redness, and swelling.
- Urethritis: Inflammation of the urethra, typically caused by infection, leading to painful urination and possibly penile pain.
- Penile Fracture: A painful condition that occurs when the corpus cavernosum is ruptured, often during sexual activity, presenting with sudden severe pain and swelling.
- Peyronie's Disease: A condition characterized by the development of fibrous scar tissue inside the penis, leading to curved, painful erections.
Do Not Miss Diagnoses
- Penile Cancer: Although rare, penile cancer can present with pain and must be considered to ensure early detection and treatment.
- Necrotizing Fasciitis: A severe, life-threatening infection that can cause penile pain, swelling, and necrosis of the skin and underlying tissues.
- Epididymitis or Orchitis: Inflammation of the epididymis or testis, which can cause referred pain to the penis and requires prompt treatment to prevent complications.
Rare Diagnoses
- Priapism: A condition where the penis remains erect for hours, causing pain and potentially leading to permanent damage if not treated.
- Penile Thrombosis: A blood clot in the penile veins, which is rare but can cause severe pain and requires immediate medical attention.
- Sickle Cell Disease Crisis: In patients with sickle cell disease, a crisis can cause penile pain due to vaso-occlusive episodes affecting the penis.