Painful Erections During Urination: Causes and Solutions

Q: Painful Erections During Urination: Causes and Solutions

Hello： 1) I have not encountered your issue clinically, but if you are experiencing symptoms during urination, you should seek care from a urologist at a major hospital, as further examination may be necessary. <br>2) Regarding the genital area, if there is no visible redness, sw

Erection during urination causing discomfort in the penis?

Hello, at the beginning of the year, I experienced a persistent state of penile arousal for unknown reasons, which made it difficult for me to sit still.
The area behind the penis also shrank to the size of a pinky finger.
When I sought medical attention, the doctors said it was not an abnormal erection, but medication did not help, and I still could not relax.
It shrank to a position resembling inversion.
Last month, while trying to urinate, I found that I could not pass urine; instead, it felt trapped in the urethra, as if I was experiencing a failed attempt to urinate while erect.
At that moment, my penis experienced spasms and twisting, as if it were about to break from the pressure.
After a painful episode, my penis shrank as if to protect itself.
Following this involuntary reaction, now even slight erections during urination lead to intense arousal, similar to the sensation of ejaculation.
I cannot exert too much force to relieve residual urine, which is extremely distressing.
During my consultation, the doctor advised me to exercise, lose weight, and stop my previous unhealthy habit of masturbation.
However, I still want to know if there are more proactive ways to determine the cause and improve my condition.
After all, some doctors suspect that shockwave therapy would be ineffective.
I feel that my penis may have sustained damage, but external examinations have found nothing wrong, which is very troubling.
Thank you, doctor.

walliam, 30~39 year old female. Ask Date: 2021/03/31

Dr. Du Shixi reply Urology

Hello: 1) I have not encountered your issue clinically, but if you are experiencing symptoms during urination, you should seek care from a urologist at a major hospital, as further examination may be necessary.
2) Regarding the genital area, if there is no visible redness, swelling, heat, pain, deformity, or hematoma, it is generally considered normal by most hospitals.
3) As for considering shockwave therapy, please discuss it with your physician, as they should be familiar with your situation.
Wishing you good health.

Reply Date: 2021/03/31

More Info

Understanding painful erections during urination can be a complex issue that involves multiple factors, including physical, psychological, and possibly neurological components. Based on your description, it seems you are experiencing a combination of symptoms that are causing significant distress and discomfort. Let's break down the potential causes and explore possible solutions.

Potential Causes
1. Physiological Factors:
- Urethral Stricture: A narrowing of the urethra can lead to difficulty in urination, causing pain and discomfort. This could explain the sensation of urine being "stuck" in the urethra.

- Infection or Inflammation: Conditions such as urethritis or prostatitis can cause pain during urination and may lead to painful erections. Infections can cause inflammation, leading to increased sensitivity and pain.

- Nerve Damage or Irritation: If there is any nerve involvement, such as from previous trauma or surgery, this could lead to abnormal sensations during urination and erections.

2. Psychological Factors:
- Anxiety and Stress: Psychological factors can exacerbate physical symptoms. Anxiety about urination or sexual performance can lead to muscle tension and increased sensitivity, which may contribute to the pain you are experiencing.

- Conditioned Response: If you have had painful experiences associated with urination in the past, your body may react with heightened sensitivity during future instances.

3. Lifestyle Factors:
- Excessive Masturbation: As mentioned by your doctor, habits such as frequent masturbation can lead to physical changes in the penis and may contribute to sensitivity or pain. Reducing frequency may help alleviate some symptoms.

- Obesity and Lack of Exercise: Being overweight can contribute to various health issues, including those affecting sexual health. Regular exercise can improve overall health and potentially alleviate some symptoms.

Solutions and Recommendations
1. Medical Evaluation:
- It is crucial to undergo a thorough medical evaluation by a urologist. This may include urine tests, imaging studies, and possibly a cystoscopy to visualize the urethra and bladder. Identifying any underlying physical issues is essential for effective treatment.

2. Medication:
- Depending on the diagnosis, medications such as anti-inflammatories, antibiotics (if an infection is present), or medications to relax the bladder may be prescribed. Discuss with your doctor the possibility of trying medications that target nerve pain if nerve involvement is suspected.

3. Physical Therapy:
- Pelvic floor physical therapy can be beneficial for individuals experiencing pain during urination or erections. A specialized therapist can help you learn relaxation techniques and exercises to alleviate tension in the pelvic area.

4. Psychological Support:
- If anxiety or stress is contributing to your symptoms, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can help address anxiety related to sexual performance and urination.

5. Lifestyle Modifications:
- Incorporate regular exercise into your routine to improve overall health and reduce stress. Focus on a balanced diet and consider reducing alcohol and caffeine intake, as these can irritate the bladder.

- Gradually reduce the frequency of masturbation if you believe it is contributing to your symptoms.
6. Follow-Up Care:
- Regular follow-up with your healthcare provider is essential to monitor your symptoms and adjust treatment as necessary. If symptoms persist or worsen, further evaluation may be needed.

In conclusion, while your symptoms are undoubtedly distressing, a comprehensive approach involving medical evaluation, lifestyle changes, and possibly psychological support can lead to improvement. It is essential to communicate openly with your healthcare provider about your symptoms and concerns to develop an effective treatment plan.

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