Penile Pain: Causes and Treatment Options

Q: Penile Pain: Causes and Treatment Options

Ah Hong： Hello, kidney stones can sometimes cause referred pain, which may radiate to areas such as the glans penis and testicles. <br>Topical ointments are unlikely to be effective. <br>For stone management, you can look for a lithotripter that uses ultrasound localization; it m

I have pain in my glans?

Hello doctor, I have been experiencing pain in my glans recently.
Ten years ago, I had pain due to phimosis, but after the circumcision, the pain went away.
Two years ago, I had pain from right kidney stones and uric acid stones.
I underwent several X-rays and contrast imaging, but nothing was found.
Eventually, an ultrasound revealed the stones, and after extracorporeal shock wave lithotripsy, I have been undergoing regular check-ups.
There is still a small stone in my right kidney that can only be detected by ultrasound.
The doctor advised me to drink more water, but I have not taken sodium citrate medication.
Recently, the pain has returned, sometimes quite severely.
Upon examination, the doctor mentioned that the stone is too small to be dislodged and that the uric acid stones cannot be localized by X-ray since there is no hydronephrosis.
They prescribed pain medication and medication for urethral spasms, as well as a topical cream for dermatitis to apply to my glans.
The doctor examined my glans and found nothing unusual.
I am at a loss about what to do.
X-rays cannot localize the stones, and drinking water helps with stone passage.
Can ultrasound localize them? Can gallstones cause pain in the glans? I read reports suggesting that they can affect other areas, but I suspect the stone in my right kidney is the main issue.
Please help me.
I have not had an ultrasound for gallstones, so I am unsure if I have any.
This is quite distressing.

A-Hong, 30~39 year old female. Ask Date: 2011/11/13

Dr. Xu Weikai reply Urology

Ah Hong: Hello, kidney stones can sometimes cause referred pain, which may radiate to areas such as the glans penis and testicles.
Topical ointments are unlikely to be effective.
For stone management, you can look for a lithotripter that uses ultrasound localization; it may be helpful.
You can call nearby facilities for inquiries.
Additionally, for stone prevention, aside from drinking plenty of water, it is crucial to reduce salt intake.
This includes salt added to cooked dishes, as well as salt in soups and dipping sauces (such as sweet chili sauce, hot sauce, fermented tofu, etc.).
If you can avoid them, it's best not to consume them.
Furthermore, "drinking plenty of water" means maintaining a daily urine output of 1500 cc (not just fluid intake).
Good luck!

Reply Date: 2011/11/13

More Info

Penile pain can be a distressing symptom and can arise from various causes, including infections, inflammation, trauma, or underlying medical conditions. Based on your description, it seems that you have a history of urological issues, including kidney stones and previous penile pain related to phimosis, which may complicate the current situation.

Possible Causes of Penile Pain
1. Urethritis: Inflammation of the urethra can cause pain in the glans (tip of the penis). This can be due to infections, sexually transmitted infections (STIs), or irritants.

2. Peyronie's Disease: This condition involves the development of fibrous scar tissue inside the penis, which can lead to pain and curvature during erections.

3. Skin Conditions: Conditions such as balanitis (inflammation of the glans) or dermatitis can cause localized pain and discomfort.

4. Kidney Stones: Given your history of kidney stones, it is possible that the pain you are experiencing could be referred pain from the right kidney, especially if there is a stone that is causing irritation or obstruction in the urinary tract.

5. Nerve Irritation: Sometimes, nerve issues related to the lower back or pelvis can manifest as pain in the genital area.

Diagnostic Considerations
- Ultrasound: As you mentioned, ultrasound can be a useful tool in identifying kidney stones that are not visible on X-rays. It can also help assess any potential issues with the bladder or surrounding structures.

- CT Scan: If kidney stones are suspected and ultrasound results are inconclusive, a CT scan may provide a more comprehensive view of the urinary tract.

- Urinalysis: This can help identify any signs of infection or blood in the urine, which can be indicative of stones or other urological issues.

- Physical Examination: A thorough examination by a urologist can help rule out any skin conditions or anatomical issues that may be contributing to your pain.

Treatment Options
1. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate discomfort. Prescription medications may be necessary if the pain is severe.

2. Hydration: Increasing fluid intake can help facilitate the passage of kidney stones and reduce the risk of new stone formation.

3. Topical Treatments: If a skin condition is suspected, topical corticosteroids or antifungal creams may be prescribed.

4. Surgical Intervention: If a kidney stone is too large to pass naturally, procedures such as lithotripsy (breaking the stone into smaller pieces) or ureteroscopy (removing the stone) may be necessary.

5. Follow-Up: Regular follow-up with your healthcare provider is essential to monitor the situation, especially if you have ongoing issues with kidney stones.

Conclusion
Given your complex medical history, it is crucial to work closely with a urologist who can provide a comprehensive evaluation and tailored treatment plan. If your symptoms persist or worsen, do not hesitate to seek immediate medical attention. Pain in the genital area can be multifactorial, and a thorough investigation is necessary to determine the underlying cause and appropriate management.

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