Penile Soft Tissue Pain: Causes and Solutions - Urology

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Understanding penile soft tissue pain can be complex, as it often involves various factors, including nerve sensitivity, muscle tension, and potential underlying medical conditions. Based on your description, it seems that you have been experiencing intermittent pain in the soft tissue on the left side of your penis, particularly during erections, which has persisted for about four years. You mentioned that a previous doctor suggested that this could be due to nerve damage from vigorous masturbation, and you found some relief after taking Vitamin B12 supplements.


Causes of Penile Soft Tissue Pain
1. Nerve Damage: As your doctor indicated, excessive or vigorous activities can lead to microtrauma in the soft tissues, potentially affecting the nerves. This can result in sensations of pain or discomfort during erections.

2. Peyronie's Disease: This condition involves the development of fibrous scar tissue inside the penis, which can cause pain and curvature during erections. While you did not mention curvature, it’s worth considering if the pain persists.

3. Muscle Tension: The pelvic floor muscles play a significant role in erectile function. Tension or spasms in these muscles can lead to discomfort or pain during erections.

4. Infection or Inflammation: Conditions such as prostatitis or infections in the genital area can also lead to pain. If there are accompanying symptoms like swelling, redness, or discharge, it would be important to consult a healthcare provider.

5. Psychological Factors: Anxiety or stress related to sexual performance or past experiences can also manifest as physical symptoms, including pain.


Solutions and Management
1. Medical Evaluation: It is crucial to have a thorough evaluation by a urologist. They may recommend imaging studies or nerve conduction studies to assess any underlying issues.

2. Physical Therapy: Pelvic floor physical therapy can help alleviate muscle tension and improve function. A specialized therapist can guide you through exercises to strengthen and relax the pelvic floor muscles.

3. Medications: Continuing with Vitamin B12 is a good idea, as it can support nerve health. Additionally, if inflammation is suspected, anti-inflammatory medications may be beneficial. Always consult your doctor before starting any new medication.

4. Lifestyle Modifications: Reducing the frequency of activities that may have contributed to the nerve damage, such as vigorous masturbation, can help. Engaging in relaxation techniques, such as yoga or meditation, may also reduce overall tension.

5. Counseling: If psychological factors are contributing to your symptoms, speaking with a mental health professional who specializes in sexual health can be beneficial.

6. Follow-Up: Regular follow-up with your healthcare provider is essential to monitor your symptoms and adjust your treatment plan as necessary.


Conclusion
While it is encouraging that you have experienced some relief with Vitamin B12, the recurrence of pain, especially during erections, warrants further investigation. It is essential to address both the physical and psychological aspects of your symptoms. By working closely with a healthcare provider, you can develop a comprehensive management plan tailored to your needs. Remember, open communication with your doctor about your symptoms and concerns is vital for effective treatment.