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Suggest Treatment For Penile Pain

Posted on Wed, 12 Apr 2017

Question: apporx 8 months ago, I felt pain at the tip of my Penis during erection. Pain was only during erection and for 3-4 months I just waited for it to subside. Then, I consulted and I was told that it might be due to stone in bladder. and it should go away on its own. I got USG done in Dec-16 and there was no stone detected. Meanwhile, my sexual activity was reduced. now, over past 2-3 weeks I have noticed that my Penis is not getting fully erect. I am getting arousal and also ejaculating but my erect penis size is much smaller than earlier.

Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)

Brief Answer:
Please provide more details

Detailed Answer:
Dear Sanddep,
Thanks for using Healthcaremagic again.

Please mention the following details

1. Do you still have the pain of same intensity and duration or it has been diminished over a period of time?

2. Do you get burning micturition while passing urine?

3. Serum testosterone level

4. Serum prolactin level

5. Semen analysis report

6. Blood sugar

7. Lipid profile

8. Previous USG report

9. Also mention about early morning erections. If they are present what is frequency (how many times in a week period) and intensity in compare to past.

For the 3, 4 5, 6 and 7 you will need to visit a laboratory.

Thanks again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ashok Kumar Choudhary (11 hours later)

Thanks Doctor.

1. Do you still have the pain of same intensity and duration or it has been diminished over a period of time?
>>> Pain intensity has decreased.
2. Do you get burning micturition while passing urine?
>>> No problem in passing urine
3. Serum testosterone level
>>> I shall get the test done and share the report
4. Serum prolactin level
>>> I shall get the test done and share the report
5. Semen analysis report
>>> I shall get the test done and share the report
6. Blood sugar
>>> In Dec-16, I got preventive HC done which included Blood Sugar. Can I provide the same report?
7. Lipid profile

>>> In Dec-16, I got preventive HC done which included Lipid Profile. Can I provide the same report?
8. Previous USG report
>>> OK. I will provide.

9. Also mention about early morning erections. If they are present what is frequency (how many times in a week period) and intensity in compare to past.
>>> I am not sure on this. I cannot recall about freq previously. But I shall try to keep track of it in coming days and inform you.

For the 3, 4 5, 6 and 7 you will need to visit a laboratory.
>>> OK

Answered by Dr. Dr. Ashok Kumar Choudhary (3 hours later)

Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

The presence of normal report on USG indicates that the stones were passed with urine before you went for diagnosis. The other possibility for negative report USG lies with fact that most stones impacting the urethra are very small and may not be detectable on some occasions.

I will wait for the reports and you can attach whatever is available. If there is confusion we can ask for repeat reports.

Thanks and regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ashok Kumar Choudhary (2 days later)

Thanks Doctor.

I shall get the tests #3,4,5 done today and then upload all reports together.

Regards.

Answered by Dr. Dr. Ashok Kumar Choudhary (10 minutes later)

Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

I will wait eagerly for the reports.

Thanks again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ashok Kumar Choudhary (10 hours later)

Hello Doctor, I uploaded all reports recommended. My apologies if I uploaded reports multiple times. It was because functionality of uploading reports in confusing. Please consider the last 6 reports.
regards, XXXXXXX

Answered by Dr. Dr. Ashok Kumar Choudhary (4 hours later)

Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

I have gone through the attached reports and like to inform you that there are two issues which need to be addressed.

First there is low testosterone - This could be factors for decreased interest as well as decreased sexual drive. For a person of 46 year sexually active the range should be atleast 4-5 but the current level for you is less than 3. For the correction it is recommended to start testosterone. Since it is prescription only medication you will need to see a doctor.

The second issue is high LDL cholesterol otherwise called bad cholesterol. This clearly indicates that there is need to opt for better life style which include diet modification and exercise. You need to have atleast 35-45 minutes of regular exercise to maintain the high cholesterol. I do not think there is need for medication for high cholesterol as diet and exercise will be sufficient.

I am also of the opinion that you should start simple antioxidants such as Nervon forte (IPCA) once a day or Cap Corus (Intas) 1 tab per day. This will help to some extent in loss of erections.

I hope this helps you.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Ashok Kumar Choudhary (5 hours later)

Hello Doctor,

Thanks for your response.

However, I would like your opinion on the following:

1. Cause of the pain I experience during erection. It still persists.

2. Cause of Penis not getting full erection during arousal. It likely surfaced in last 1-2 months.

regards, XXXXXXX

Regards, XXXXXXX

Answered by Dr. Dr. Ashok Kumar Choudhary (4 hours later)

Brief Answer:
Follow up

Detailed Answer:
Dear XXXXXXX
Thanks for follow up.

As explained earlier the cause of pain at the tip of penis is impaction at urethra due to some external factors. As stated above it was detected probably because the size was too small to get detected on the USG.

I will recommend plenty of water intake to control this pain. In addition a seven day course of nitrofurontoin can be considered if there are evidence if urinary infection such as continuing pain.

For the erection part in addition to above explained matters it is possible that the fear of pain on erection caused problem in erection. It is possible that with correction of above deficiencies and reduction of pain you will improve over the course of time.

I do not think you need to worried as most of these issues are treatable.

I hope this assists you further.
Thanks and regards.

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Above answer was peer-reviewed by : Dr. Kampana