From the Guidelines
Penile pain during erection is most likely caused by conditions such as priapism, Peyronie's disease, or other factors that restrict blood flow or cause inflammation, and it is essential to seek medical evaluation for proper diagnosis and treatment. The pain can occur due to various reasons, including:
- Restriction of blood flow
- Inflammation
- Physical tension in penile tissues during erection Some possible causes of penile pain during erection include:
- Priapism, which is a prolonged erection that can be painful and requires prompt medical attention 1, 2, 3
- Peyronie's disease, which is a condition characterized by scar tissue formation in the penis, leading to curved and painful erections 4, 5
- Phimosis, which is a condition where the foreskin is too tight, causing pain and discomfort during erection
- Infections, such as balanitis or sexually transmitted infections, which can cause pain and inflammation in the penis
- Trauma or injury to the penis, which can cause pain and discomfort during erection
- Prostatitis, which is an inflammation of the prostate gland, can cause pain in the penis, testicles, and surrounding areas
- Psychological factors, which can contribute to penile pain during erection
It is crucial to seek medical evaluation for persistent penile pain, as delaying treatment can lead to permanent erectile dysfunction or other complications. A proper diagnosis is essential for effective treatment, and a healthcare professional can help determine the underlying cause of the pain and recommend appropriate treatment options, such as:
- NSAIDs like ibuprofen for temporary pain management
- Oral medications like pentoxifylline for Peyronie's disease
- Procedures like collagenase injections for Peyronie's disease
- Steroid creams or surgical intervention for phimosis
- Antibiotics or antifungals for infections
- Treatment for prostatitis or other underlying conditions
According to the most recent and highest quality study, the management of priapism, a condition that can cause penile pain during erection, requires prompt evaluation and treatment to prevent complications 3. The study highlights the importance of differentiating between ischemic and non-ischemic priapism and provides guidance on the management of recurrent ischemic priapism, priapism in sickle cell patients, and non-ischemic priapism.
From the Research
Possible Causes of Penile Pain during Erection
- Penile pain during erection can be caused by various factors, including Peyronie's disease, a condition characterized by the formation of collagen plaques on the tunica albuginea of the penis, leading to penile deformity, pain, and erectile dysfunction 6, 7, 8, 9.
- Peyronie's disease is a progressive fibrotic disorder that can result in penile deformity, pain, and erectile dysfunction, with symptoms that may physically limit intercourse and impose a severe physical and psychological burden 9.
- The disease has two phases: an early 'inflammatory' phase that may last 1-18 months, during which patients may experience penile pain as the tunical plaque develops, and a subsequent 'stable' phase, during which the plaque becomes more organized, penile curvature stabilizes, and the pain usually subsides 9.
Treatment Options for Peyronie's Disease
- Treatment options for Peyronie's disease vary based on symptom severity and stability, and may include oral therapies, penile traction therapy, intralesional injections, and surgical interventions such as penile straightening and penile prosthesis implantation 6, 7, 8.
- Intralesional collagenase injections have the strongest evidence and are the only FDA-approved intralesional treatment for Peyronie's disease, while penile traction therapy is low-risk and may be beneficial in patients willing to invest significant time using the devices 8.
- A systematic review and network Bayesian meta-analysis found that there was no statistically significant treatment compared to placebo for curvature degree, plaque size, and structured questionnaires, but frequentist analysis showed that some treatments, including coenzyme Q10, hyperthermia device, and penile traction therapy, were statistically significant for improvement of curvature degree and plaque size 10.
Importance of Medical Evaluation and Counseling
- It is essential for patients with Peyronie's disease to receive a comprehensive evaluation and in-depth counseling to understand the natural disease course and have appropriate expectations of each treatment option 7.
- Patients may be hesitant to discuss their symptoms unless inquired directly, and may not be aware that treatments exist, highlighting the need for attentive patient counseling and education 7.