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Last updated: June 5, 2025View editorial policy

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Differential Diagnosis for Penile Pain and Swelling

  • Single most likely diagnosis
    • Paraphimosis: This condition is characterized by the retraction of the foreskin behind the glans penis, which can cause swelling, pain, and redness. The presence of a band of constrictive tissue behind the glans and the patient being uncircumcised supports this diagnosis.
  • Other Likely diagnoses
    • Gonorrhea: As a sexually transmitted infection, gonorrhea can cause penile discharge, pain, and swelling, especially in a recently sexually active individual.
    • Hydrocele: Although less likely given the acute presentation and associated symptoms, a hydrocele (fluid accumulation around a testicle) could potentially cause swelling, but it's more commonly associated with the scrotum rather than the penis itself.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Necrotizing fasciitis: Although rare, this is a severe infection that can quickly progress and is life-threatening. The presence of severe pain, swelling, and redness could be indicative of this condition, especially if the patient's condition rapidly deteriorates.
    • Priapism: This condition involves a prolonged erection that can cause pain and swelling. If not promptly treated, it can lead to permanent damage.
  • Rare diagnoses
    • Varicose veins: While varicose veins can occur in the scrotum (varicocele), they are less commonly associated with the penis itself and would not typically cause acute pain and swelling.
    • Inguinal hernia: Although an inguinal hernia can cause swelling in the groin area, it is less likely to cause pain and swelling localized to the penis.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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