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 trapped behind the glans penis (paraphimosis), leading to pain, swelling, and potentially severe complications if not addressed promptly.
- Other Likely diagnoses
- Balanitis: An inflammation of the glans penis, often caused by poor hygiene, infections (bacterial, fungal, or viral), or allergic reactions, leading to pain, redness, and swelling.
- Urinary tract infection (UTI): While more common in women, men can also experience UTIs, which may cause penile pain, especially during urination.
- Epididymitis: An inflammation of the epididymis (the tube behind the testicle that stores and carries sperm), often caused by bacterial infections, leading to pain in the testicle and potentially the penis.
- Peyronie's disease: A condition characterized by the development of scar tissue inside the penis, leading to curved, painful erections.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Penile fracture: A rare but serious condition that occurs when the penis is subjected to severe bending or trauma, causing a rupture of the tunica albuginea, which requires immediate medical attention to prevent long-term damage.
- Penile cancer: Although rare, penile cancer can present with pain and should be considered, especially in high-risk individuals (e.g., those with a history of HPV infection or poor genital hygiene).
- Necrotizing fasciitis: A severe bacterial infection that can cause rapid destruction of tissue, including the penis, and is life-threatening if not promptly treated.
- Rare diagnoses
- Fabry disease: A genetic disorder that can lead to the accumulation of a particular type of fat in the body's cells, affecting many parts of the body and potentially causing penile pain.
- Sickle cell disease: A condition that affects hemoglobin production, leading to abnormally shaped red blood cells, which can cause episodes of pain, including penile pain, due to vaso-occlusive crises.
- Penile vasculitis: Inflammation of the blood vessels in the penis, which can cause pain and is associated with various systemic diseases.