Disorders of the Penis

Erectile Dysfunction and Penis

The penis is one of the external structures of the male reproductive system. The penis has three parts: the root, which attaches to the wall of the abdomen; the body, or shaft; and the glans penis, which is the cone-shaped end (head). The opening of the urethra, the tube that transports semen and urine, is at the tip of the glans penis.

The body of the penis is cylindrical in shape and consists of three internal chambers. These chambers are made up of special, sponge-like erectile tissue. This tissue contains thousands of large caverns that fill with blood when the man is sexually aroused. As the penis fills with blood, it becomes rigid and erect, which allows for penetration during sexual intercourse. The skin of the penis is loose and elastic to accommodate changes in penis size during an erection.

Semen, which contains sperm (the male reproductive cells), is expelled through the end of the penis when the man reaches sexual climax (orgasm). Disorders of the penis can affect a man's sexual functioning and fertility.

What disorders affect the penis?

Some disorders that affect the penis include the following:

Priapism

Priapism is a persistent, often painful erection that can last from several hours to a few days. The priapism erection is not associated with sexual activity and is not relieved by orgasm. It occurs when blood flows into the penis but is not adequately drained. Common causes of priapism include:

• Alcohol or drug abuse (especially cocaine)
• Certain medications, including some antidepressants and blood pressure medications
• Spinal cord problems
• Injury to the genitals
• Anesthesia
• Penile injection therapy (a treatment for erectile dysfunction)
• Blood diseases, including leukemia and sickle cell anemia

Treatment for priapism is important, because a prolonged erection can scar the penis if not treated. The goal of treatment is to relieve the erection and preserve penile function. In most cases, treatment involves draining the blood using a needle placed in the side of the penis. Medications that help shrink blood vessels, which decreases blood flow to the penis, also may be used. In rare cases, surgery may be required to avoid permanent damage to the penis. If the condition is due to sickle cell disease, a blood transfusion may be necessary. Treating any underlying medical condition or substance abuse problem is important to preventing priapism.

Peyronie's disease

Peyronie's disease is a condition in which a plaque, or hard lump, forms on the penis. The plaque may develop on the upper (more common) or lower side of the penis, in the layers that contain erectile tissue. The plaque often begins as a localized area of irritation and swelling (inflammation), and can develop into a hardened scar. The scarring reduces the elasticity of the penis in the area affected.

Peyronie's disease often occurs in a mild form that heals without treatment in six to 15 months. In these cases, the problem does not progress past the inflammation phase. In severe cases, the disease can last for years. The hardened plaque reduces flexibility, causing pain and forcing the penis to bend or arc during erection.

In addition to the bending of the penis, Peyronie's disease can cause general pain as well as painful erections. It also can cause emotional distress, and affect a man's desire and ability to function during sex.

The exact cause of Peyronie's disease is unknown. Cases that develop quickly, last a short time and go away without treatment most often are due to a trauma (hitting or bending) that causes bleeding inside the penis. Some cases of Peyronie's disease, however, develop slowly and are severe enough to require surgical treatment. Other possible causes of Peyronie's disease include:

• Vasculitis