Pain During Erection: Causes and Solutions - Urology

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Understanding pain during erection can be a complex issue, as it may stem from various underlying causes. The symptoms you describe—pain during erection, a sensation of something being "stuck," and discomfort during ejaculation—are concerning and warrant further investigation.
Firstly, it’s important to understand that pain during an erection can be caused by several factors, including but not limited to:
1. Peyronie's Disease: This condition involves the development of fibrous scar tissue inside the penis, which can lead to painful erections and curvature of the penis. It often results in discomfort during sexual activity and can affect the ability to ejaculate.

2. Infection or Inflammation: Conditions such as prostatitis (inflammation of the prostate gland) or urethritis (inflammation of the urethra) can cause pain during erections. These infections may also lead to discomfort during ejaculation.

3. Nerve Damage: Nerve issues, possibly due to previous trauma or surgery, can lead to abnormal sensations or pain during erections. This could also explain the feeling of something being "stuck."
4. Vascular Issues: Problems with blood flow to the penis can lead to pain during erections. Conditions such as atherosclerosis or other vascular diseases can affect the blood vessels and lead to discomfort.

5. Psychological Factors: Anxiety, stress, or psychological trauma can manifest as physical symptoms, including pain during sexual arousal or activity.

Given that you have experienced this pain for over a year and it has worsened, it is crucial to seek a thorough evaluation from a urologist. While the initial assessments you received may have suggested that your age makes certain conditions less likely, persistent pain should not be dismissed. A urologist can perform a comprehensive examination, which may include:
- Physical Examination: A thorough physical examination can help identify any abnormalities.

- Ultrasound: This imaging test can assess blood flow to the penis and identify any structural issues.

- Blood Tests: These can help rule out infections or hormonal imbalances.

- Urinalysis: A urine test can check for signs of infection or other urinary tract issues.

In terms of treatment, the approach will depend on the underlying cause identified. Options may include:
- Medications: If an infection is present, antibiotics may be prescribed. For Peyronie's disease, treatments may include medications to reduce the curvature and pain.

- Physical Therapy: Pelvic floor physical therapy may help if muscle tension or nerve issues are contributing to the pain.

- Surgery: In cases of severe Peyronie's disease or other structural issues, surgical intervention may be necessary.

- Counseling: If psychological factors are involved, therapy may help address anxiety or stress related to sexual activity.

It’s essential to communicate openly with your healthcare provider about your symptoms and concerns. Pain during erection is not normal and should be addressed promptly to prevent further complications and to improve your quality of life. Seeking a second opinion or a referral to a specialist may also be beneficial if you feel your concerns are not being adequately addressed. Remember, your health and comfort are paramount, and there are solutions available.