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    Suggest treatment for elevated bumps on penis and tunica albuginea

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Posted on Mon, 23 Mar 2015 in Urinary and Bladder Problems
Question: I asked a question earlier: http://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=169487

A brief summery, I suffered an injury to my erection resulting in a sharp pain and two elevated bumps on my penis. The result was most likely a superficial injury to my tunica albuginea and not a complete penile fracture. There are two semi circumferential bumps where the injury occurred. I can roll the skin over them and the bumps do not move. They also grow in size when I get an erection.

It's been 2 weeks and my condition has neither improved nor gotten worse.

I have seen several Urologists since asking my first question. Upon physical examination it was confirmed that there was most likely damage to the tunica. I requested an ultrasound or any other scan to rule out any major injury to my tunica with several different doctors but I was denied every time. I was told there is no scan to rule out damage to the tunica albuginea, and even if they did find something, nothing can be done about it anyway so imaging is a waste of time.

I was also told injuries to the tunica albuginea typically do not heal very well or completely. Is this true? Is there really nothing that can be done about it? Is this something that can heal completely over time, or is it likely to stay damaged and result in a weak spot in the sheath?

I wanted to get a scan to rule out permanent damage or injury even if no medical intervention was necessary. If it is something that is likely to heal completely over time and result in no long term pain or erectile dysfunction I don't care, but if it is a case that results in permanent erectile dysfunction there might be legal ramifications of it (for the unusual circumstances of how the injury occurred), but I am unable to get a ultrasound ordered even if I'm paying the full price out of pocket for it.

How long do superficial tears / injuries to the tunica albuginea take to completely heal? Or do they ever really completely heal?
Is there really no use in medical imaging for an injury to the penis in the non-emergency setting?

Thanks for your time.
doctor
Answered by Dr. Deepak Kishore Kaltari 32 hours later
Brief Answer:
The link term outlook is good

Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day

Dear Sir

First and foremost let me reassure you there is no cause for concern. I have gone through previous photograph provided by you , there does not appear to be any gross deformity of Penis.

As Tunica Albuginea is a sheath covering the erection issues ( Two corpus cavernosa and one corpus spongiosum ). Partial disruption of Albuginea heals with clotting of blood and later organisation of blood which latter gets organised with mild fibrosis. As there is no gross deformity of penis , Ultrasound is not likely to be helpful. The tear heals completely by 3 to 6 weeks time frame and long term outlook us good with regards to erection. As the erectile tissues are not affected which is very reassuring.

You can continue with your normal routine after a week.

Do get back to me if you need any further assistance, will be glad to assist you.


Take care

Best regards
Dr Deepak Kaltari
Consultant Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Deepak Kishore Kaltari 23 hours later
Thanks.
I can still get erections, which is reassuring, but they don't last very long. I have been avoiding sex and masturbation since the injury. The swelling does seem worse after getting an erection, but it remains localized to the two bumps.

From my understanding the Tunica Albuginea is not is not directly involved in maintaining an erection but it does help create the hardness of an erection. The other layer, the buck’s fascia, is what maintains the erection. Is this correct? When one injures their erection, does it typically tear through both the Albuginea and the buck's facia? Is it possible to only tear one and not any of the layers beneath, and would this effect the type and severity of swelling you see?

Can Pentoxifylline aid in the repairing of a damaged Albuginea and help prevent too much fibrosis/scaring?
doctor
Answered by Dr. Deepak Kishore Kaltari 2 hours later
Brief Answer:
Pentoxifylline will not be helpful

Detailed Answer:
Dear Sir


Neither Buck's fascia nor tunica is involved in maintaining erection. Erection is maintained by pooling of blood in the corpus tissue of penis which is aided by vasodilation (IIncrease in size of blood vessels ) and decreased venous return. The erection is maintained by release of vasodilator ( Nitric Oxide ) from the endothelial lining of blood vessels usually brought about by stimulation of nerves .

The cause of your less lasting erection is mainly due to psychological factors associated with stress and anxiety due to injury sustained . I would suggest you to put back the incident and continue ahead , the two bumps you notice should also improve with time .

Pentoxifylline is a rheodilator ( increases the flexibility of red blood cells ). It does not affect the outcome of fibrosis nor reduces it.


Do destress yourself and things should be fine.


Wishing you great Health


Best regards
Dr Deepak
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Deepak Kishore Kaltari 3 days later
Thanks, I'll try to take my mind off it more. It's been 3 weeks and I would have hoped to see some improvement by now. I still get some discomfort in the area (especially after having been aroused). Does getting erections interfere with the healing process as the tunica is being stretched? I grow a lot when getting erect, more than normal, many times flaccid size.

Thanks for answering my questions.
doctor
Answered by Dr. Deepak Kishore Kaltari 2 hours later
Brief Answer:
Erection will not affect healing

Detailed Answer:
Dear Sir


Erection will not affect the healing of Tunica Albuginea. There is absolutely no cause for concern.

Wishing you great Health

Best regards
Dr Deepak
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Deepak Kishore Kaltari

General Surgeon

Practicing since :2002

Answered : 3193 Questions

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