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Last updated: September 26, 2025View editorial policy

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Differential Diagnosis for Penile Pain

Single Most Likely Diagnosis

  • Phimosis or Paraphimosis: This condition is characterized by the inability to retract the foreskin (phimosis) or the foreskin getting stuck behind the glans penis (paraphimosis), leading to pain, swelling, and sometimes urinary retention. It's a common cause of penile pain, especially in uncircumcised males.

Other Likely Diagnoses

  • Balanitis: An inflammation of the glans penis, often caused by poor hygiene, infections (bacterial, fungal, or viral), or allergic reactions. Symptoms include pain, redness, and swelling of the glans.
  • Urethritis: Inflammation of the urethra, typically caused by sexually transmitted infections (STIs) like gonorrhea or chlamydia, leading to painful urination and penile discharge.
  • Penile Fracture: A painful condition that occurs when the corpus cavernosum is ruptured, usually during vigorous sexual activity. It presents with sudden, severe pain, swelling, and deformity of the penis.

Do Not Miss Diagnoses

  • Penile Cancer: Although rare, penile cancer can present with pain and should not be missed due to its potential for severe morbidity and mortality. Risk factors include poor hygiene, smoking, and HPV infection.
  • Epididymitis or Orchitis: Inflammation of the epididymis or testis, often due to bacterial or viral infections, which can cause referred pain to the penis. These conditions require prompt treatment to prevent complications like infertility.
  • Priapism: A condition characterized by prolonged erection of the penis without sexual stimulation, which can be painful and is a medical emergency. It can be caused by certain medications, sickle cell disease, or leukemia.

Rare Diagnoses

  • Peyronie's Disease: A condition where fibrous scar tissue forms on the penis, leading to curved, painful erections. It's more common in older men and can be associated with trauma or certain health conditions.
  • Lichen Sclerosus: A chronic inflammatory skin condition that can affect the penis, causing pain, itching, and skin changes. It's more common in uncircumcised males and can increase the risk of penile cancer if left untreated.

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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