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Broken Penis Shaft, Pain On Urinating, Itching, No Erection. Treatment ?

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Posted on Sat, 26 May 2012
Question: I am 40 year old, 170 Cms height and 65 Kg weight. I got my penis shaft broken and undergone surgery recently on 17 Jul 11. This injury occurred during intercourse while accidently strike outside on the pelvis bone side. I was admitted in hospital for 12 days. The procedure which was understood to me that my penis was ungloved around from the penis head side, shaft was repaired and developed and then dissolveable stitches were given. Catheter was installed during surgery but being having problem same was changed on very second day of surgery and finally on fourth day it was removed. The catheter procedure was very painful. Now, as around 4 weeks have passed, I am facing problem while urinating, sometime of itching and pain comes. Moreover, frequency of urinary intervals is more then normal. Still, I feel something pinching inside, are these stitches which have not been dissolved yet. The main thing, since the day of surgery, foreskin of penis is covering the penis head, I have not pulled it back and not even tried as it's painful. Kindly intimate me that, if there are any chances of infection due to not cleaning inside foreskin since a long time. My doctor told me to avoid erection for 3-4 weeks, so I am adhering same. Kindly give advice on above. Can I pull back foreskin or should wait to XXXXXXX doctor as appointment received for 21 Jul. Thanks
doctor
Answered by Dr. Dr. Rakhi Tayal (2 hours later)
Hello.
Thanks for writing to us.
The pinching sensation in the penis that you are feeling is because of the ends of the suture material which remains after putting a knot in it. It takes almost 2-3 months ( near about 70-90days) for the suture material to dissolve completely.
Feeling of itching and pain during urination is due to the movement that occurs in the repaired shaft muscles. This is also likely to subside in the three months time.
You can gently pull back the foreskin to clean the glans with soap and water as this part is not meddled with during the surgery so there should not be any pain in doing so.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.
Wishing you good health.
Regards.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rakhi Tayal (16 hours later)
Doctor, as you mentioned that I can pull back foreskin because glans art is not meddled with during surgery. My question is that, if inside the foreskin there is no surgery/stitches then where they have made stitches or cut. I am satisfied with your reply which gave me confidence and cleared my doubts. Before, I pull my skin back for cleaning purpose, Kindly if U can mentioned me that apart from repairing inside the shaft muscles where stitches are made, from where doctors have made entry for doing all this surgical procedure. This will be very helpful for me and will give me a confidence to handle the cleaning and come out of other anxieties. Thanks.
doctor
Answered by Dr. Dr. Rakhi Tayal (2 hours later)
Hello,

Thanks for writing again.

The joint between the glans and shaft is the area where incision is made in a circular way.

You were operated one month ago. For the skin to heal, it takes 7-10 days only. All your stitches would have healed by now.

You can safely clean the area and remove the remnants of the suture material that are left there.

Hope my answer is helpful.

Wishing you a trouble free speedy recovery.

Regards,
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dr. Rakhi Tayal (23 hours later)
Dear Doctor,
As suggested in reply to my second question, I have tried today to pull back my foreskin during bath. Same could not happen, I find the outer end circumference/skin ring is shorten then the size of outer ring of penis head. Penis head in normal position (without any erection) found to be bigger then the outlet/ neck of foreskin. I have tried a lot, even applied coconut oil and mild Dettol soap. Taken a lot of time but all in vain. Lastely, I left as it is and some how little bit cleaned by pouring mild hot water and dettol soap, but head could not come out due to small ring size. End ring of foreskin seems to be shorten around 25 – 30 % then the girth of the head.
I am very much worried for future, will it settle down automatically or some more surgery procedure will be required ? Why the head size seems to be bigger then the earlier time ? Sometime, it has sensation of mild erection then it pains as may be head not having finding exit thru foreskin. Kindly suggest me on further, I will be meeting my surgen on 27 Jul only. Before that, kindly help me out by giving more facts. Is there any possibility of any malfunctioning during surgery that while repairing/ stitching outer skin was tightened more or any further surgery may be required. Thanks.
doctor
Answered by Dr. Dr. Rakhi Tayal (2 hours later)
Hello,

Thanks for writing again.

There is no need to worry about the shortness of foreskin. It is an elastic tissue and will open up in time. You can give it a daily try after using coconut oil or Vaseline. There is no need to worry about an further surgery.

If the worse comes and it remains stiff and tight, then just a small procedure- circumcision will help you.

Hope this will ease out your worries.

Wish you a good health.

Thanks and regards.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Dr. Rakhi Tayal (142 days later)
Dear Sir/ Madam,

1. After the above questions, I met my surgeon who adviced me to wait for foreskin recovery which as is flexible and will come in actual position by time. Skin problem almost was recovered but problem on passing urine without any pain was not resolved.

2. I got checked up at Urologist and who found formation of "STRICTURE" in my urithera. One day come, when almost I was unable to pass urine, my bladder was full of water and paining hard. I reported to Urology hospital at Ahmedabad and they tried hard with all types of foley's catherors thru urithera but all fail, so they punctured on my belly and got passed urine. Now, a Supera Pubic Cathetor has been installed permanently since 3 days and I am at home.

3. Meanwhile, they prescribed me Cystourethoscopy after all the due tests. I underwent all tests and result is well. Since last three days, I am feeling comfort much then urinating from actual place.

4. My question is that while going for stool, I feel sensation of urinating from actual place and feel some force on my XXXXXXX and also some type of itching feeling is there. My penis, XXXXXXX is dry and coming on some while gelly cover. Can I apply some coconut oil or anything else for dryness of XXXXXXX and inner skin of penis. Is this normal during SPC diversion ? Please suggest on the problem.
doctor
Answered by Dr. Dr. Rakhi Tayal (18 hours later)
Hello.
Thanks for writing again.
It was unfortunate that there was a stricture in the urethra and you had to have a suprapubic cystostomy.
While passing stool, it is normal to feel some pressure in the normal pathway that is, urethra. Due to disuse, it is normal to have a jelly like cover on the urethra and dryness. You can use coconut oil locally for relief.
I hope my answer is helpful. Further queries are welcome.
Please accept my answer in case you do not have further queries.
Wishing you a trouble free speedy recovery.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Dr. Rakhi Tayal (2 days later)
Thanks, doctor,

1. Today even having SPC while passing stool, I got some 8-10 drops thru original place. Is it normal or some other reason. I have started moving and going to office.

2. My doctor is planning for stent placement in urethera but due to heavy stricture, urethera is totally blocked. He is saying its due to infection or swelling inside which will heal within 3-4 weeks and given medicine for it keeping me pending for cystouretheroscopy.

3. Kindly, give details on the issue, as I am worried having uro bag attached for long period and all the above procedure. Kindly reply in detail.
doctor
Answered by Dr. Dr. Rakhi Tayal (6 hours later)
Hello.

Thank you again for writing back.

Passing mild amount of urine from normal opening is a good thing indicating that your stricture is improving.
For a severely strictured urethra, stent placement is the only option. The conditions suitable for stent placement can be best assessed by your treating Urologist.

The swelling usually subsides with the help of good anti inflammatory agents and drugs like trypsin- chymotrypsin.

You can discuss your urologist regarding these medicines.

Cysto urethroscopy will help in visualisation of the exact site of stricture and stent placement.

Using urobag for long time can predispose you to bladder infections but you do not have much option.

Observing good hygiene will help in preventing infection.

Wishing you an early recovery.

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Rakhi Tayal (59 days later)
Dear Doctor,
1.      Please refer my earlier questions and your answers.
2     I underwent buccal grafting end to end dorsal Uretheroplasty for stricture around 2 cm on 23 XXXXXXX 12. And after seven days of hospitalisation I was sent to home for review on 07 Feb 12 and 14 Feb 12.
3.     I am having both catheter in-situ i.e. SPC and PUC. I am having adequate (around 2.5 ltr) discharge of urine in SPC uro-bag but nothing is coming from PUC. Instead, since then some liquid like urine + blood in drops are coming out of PUC pipe as well as thru penis where catheter is inserted. Hardly daily 5-10 drops come thru catheter pipe or from end of penis. I use to bath daily and apply good soap/ dettol on my operated portion beneath my urinary part. All the stitches are OK and not paining at all.
4.     I want to know that in general when these catheters are removed after such surgery ? Secondly, this fluid which is dark brown/rusty type is in general passes in all cases. When I will be able to urinate naturally from original place ? Kindly give comments in details. What are the normal period of being FIT for everything after such surgery ?
     Thanks.
doctor
Answered by Dr. Dr. Rakhi Tayal (49 minutes later)
Hello and thanks again,

It is nice to know that you have got yourself operated.

The mild discharge which is coming from Per Urethral Catheter (PUC) is likely to be some local wound probably mucosal wound secretions mixed with blood and urine. This discharge is not worrisome and does not indicate infection.

As long as Supra pubic catheter (SPC) is in place, only minimal urine will come out of PUC. Usually SPC is removed after first 14 days after the surgery. And ysually the healing takes 3-4 weeks.

Though it would be extremely difficult to predict, if everything goes fine, you should be able to pass urine normally by 3 weeks post operatively.
Taking a good and healthy diet will help in early recovery.

Hope this answer is both informative and useful to you. Do accept the answer if you do not have any further queries.

Wish you a trouble free recovery.

Regards
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Dr. Dr. Rakhi Tayal

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Broken Penis Shaft, Pain On Urinating, Itching, No Erection. Treatment ?

Hello.
Thanks for writing to us.
The pinching sensation in the penis that you are feeling is because of the ends of the suture material which remains after putting a knot in it. It takes almost 2-3 months ( near about 70-90days) for the suture material to dissolve completely.
Feeling of itching and pain during urination is due to the movement that occurs in the repaired shaft muscles. This is also likely to subside in the three months time.
You can gently pull back the foreskin to clean the glans with soap and water as this part is not meddled with during the surgery so there should not be any pain in doing so.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.
Wishing you good health.
Regards.