Persistent Penile Injury After Intercourse: Causes and Solutions

Q: Persistent Penile Injury After Intercourse: Causes and Solutions

Hello： The symptoms do not appear to be related to a sexually transmitted infection, but it may take longer to assess once the wound has fully healed. <br>Repeated skin breakdown may make the wound more difficult to recover. <br>Consider using condoms as well. <br>Wishing you goo

Penile trauma

Hello Doctor: About three months ago, after engaging in sexual intercourse with my regular partner, I noticed bleeding from an injury at the junction of the glans and the foreskin.
After consulting a urologist, the doctor prescribed Meizhong ointment for application.
After about a week, there was improvement, and the injured area returned to its normal skin color.
However, during subsequent sexual intercourse, the same injury reoccurred.
I then consulted another clinic, where the doctor prescribed Mometasone cream, which also healed after about a week.
Recently, after another sexual encounter, the same injury reappeared.
This time, I consulted a dermatologist, who prescribed a non-steroidal ointment, Clindamycin, which initially also healed within 1-2 weeks.
However, during the next sexual intercourse, the injury still recurred, and the wound reappeared.
(I used KY lubricant during intercourse to reduce friction, but did not use a condom.) This issue has been troubling me for a long time, and it has not improved.
Although the appearance of the wound has healed and matches the surrounding skin color, I still experience similar abrasions and bleeding at the end of sexual intercourse.
After several consultations, the doctors have all concluded that it should not be a sexually transmitted disease issue.
The injury does not occur at the beginning of intercourse, but approximately 15 minutes into it, leading to the need to apply Clindamycin ointment after each sexual encounter.
I have to wait for about a week for the surface of the injury to appear healed before engaging in intercourse again, but the injury phenomenon still occurs.
I have never experienced such a condition before, and it has been ongoing since it first occurred three months ago.
I truly do not know what to do.
I kindly ask the doctor for clarification.
Thank you for your patient response.
Take care.

Mr. Deng, 30~39 year old female. Ask Date: 2021/10/18

Dr. Du Shixi reply Urology

Hello: The symptoms do not appear to be related to a sexually transmitted infection, but it may take longer to assess once the wound has fully healed.
Repeated skin breakdown may make the wound more difficult to recover.
Consider using condoms as well.
Wishing you good health.

Reply Date: 2021/10/18

More Info

Persistent penile injuries after intercourse can be a distressing issue, and it is essential to understand the underlying causes and potential solutions. Based on your description, it appears that you have experienced recurrent injuries at the same site on your penis, specifically at the junction of the glans and the foreskin. This has led to bleeding and the need for topical treatments, which provide temporary relief but do not resolve the issue entirely.

Possible Causes
1. Friction and Trauma: The most common cause of such injuries is friction during intercourse. Even with the use of lubricants like KY, if the friction is excessive or if there is an anatomical issue, it can lead to abrasions or lacerations. The fact that the injury occurs after approximately 15 minutes of intercourse suggests that there may be a specific movement or position that exacerbates the friction.

2. Anatomical Variations: Some individuals may have anatomical variations, such as a tight foreskin (phimosis) or a frenulum that is too short, which can lead to increased tension during sexual activity and result in injury.

3. Skin Sensitivity or Conditions: Certain skin conditions, such as dermatitis or infections, can make the skin more susceptible to injury. Even if sexually transmitted infections (STIs) have been ruled out, other dermatological issues could be at play.

4. Healing Process: If the area does not heal properly between sexual encounters, scar tissue may form, which can be more prone to injury. This could create a cycle of injury and healing that perpetuates the problem.

Recommended Solutions
1. Consult a Urologist: Since you have already seen multiple specialists, it may be beneficial to return to a urologist who specializes in sexual health. They can conduct a thorough examination and may suggest further diagnostic tests, such as a biopsy or imaging studies, to rule out any underlying conditions.

2. Consider a Dermatological Evaluation: If you haven't already, a consultation with a dermatologist specializing in genital skin conditions may provide insights into whether there is an underlying skin issue contributing to your injuries.

3. Modify Sexual Practices: You might consider adjusting your sexual practices. This could include:
- Using more lubrication to reduce friction.

- Trying different positions that may reduce pressure on the affected area.

- Taking breaks during intercourse to minimize irritation.

4. Topical Treatments: Continue using the prescribed topical treatments, but discuss with your doctor the possibility of using a barrier cream or ointment that can protect the area during intercourse.
5. Avoid Irritants: Ensure that any products used in the genital area, including soaps and lotions, are gentle and free from irritants that could exacerbate sensitivity.

6. Consider Circumcision: In some cases, circumcision may be recommended if the foreskin is contributing to the problem. This is a more permanent solution that can eliminate the risk of injury at the site.

7. Follow-Up Care: Regular follow-ups with your healthcare provider are essential to monitor the healing process and make adjustments to your treatment plan as necessary.

Conclusion
Persistent penile injuries can be complex and multifactorial. It is crucial to work closely with healthcare professionals to identify the underlying cause and develop a comprehensive treatment plan. Open communication with your partner about the issue may also help in finding solutions that work for both of you. Remember, it is essential to prioritize your health and well-being, and seeking further medical advice is a positive step toward resolution.

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