Diseases of the penis: openly discussed, discreetly treated
Complaints affecting the penis often remain unspoken for a long time, out of shame or in the hope that something will resolve on its own. That costs time, which matters with some findings. We treat these conditions matter-of-factly and without circumlocution, with the aim of preserving function and appearance.
Penile curvature (induratio penis plastica)
In induratio penis plastica, a connective-tissue hardening (plaque) forms in the erectile tissue, leading to curvature during erection. Pain and a shortening often accompany it, frequently also an erectile dysfunction. The disease runs in two phases: an active, inflammatory phase with pain and increasing curvature, and a stable phase in which the findings no longer change.
In the active phase we treat conservatively and observe the course. Surgery is performed only once the findings have been stable for several months and the curvature impedes intercourse. Depending on the degree of curvature and erectile capacity, the options are straightening by plication of the opposite side, plaque correction with tissue reconstruction, or, in the presence of accompanying severe erectile dysfunction, implantation of a penile prosthesis. Which path fits, we clarify with you after precise measurement and functional assessment.
Congenital penile curvature
A curvature can also exist without a plaque, as a congenital form that usually only becomes apparent with the onset of sexual activity. It can be corrected surgically, as a rule by straightening the longer side of the penis.
Foreskin narrowing (phimosis) and shortened frenulum
If the foreskin cannot be retracted, or only with pain, this is called a phimosis. In adults, a scarred narrowing or a skin disease is often behind it. Mild forms we treat initially with a cortisone-containing ointment; with a scarred or recurrent narrowing, circumcision is the reliable solution. A frenulum that is too short, tearing or hurting during intercourse, we correct with a small, function-preserving procedure (frenulotomy).
Inflammation of the glans and foreskin (balanitis, balanoposthitis)
Redness, burning, itching, and discharge under the foreskin are typical of an inflammation of the glans and inner foreskin. Causes range from fungal and bacterial infections through skin reactions to accompanying features of diabetes. We clarify the cause instead of merely dampening the complaints, because recurrent inflammations can themselves lead to a phimosis.
Lichen sclerosus
Lichen sclerosus is a chronic inflammatory skin disease that on the penis mainly affects the glans and foreskin and leads to whitish, firm scarring. It deserves attention because, untreated, it can narrow the urethral opening and is considered a risk factor for malignant changes. Treatment is initially with potent cortisone preparations. If the scarring at the foreskin progresses, a phimosis frequently results. In that case, circumcision is advisable; it eliminates the narrowing and at the same time removes the principally affected tissue.
Penile carcinoma
Malignant tumors of the penis are rare but readily treatable when detected early. Any non-healing change on the glans or foreskin, any suspicious nodule or ulcer, should be examined promptly. Wherever the findings allow, we opt for organ-preserving procedures and coordinate the treatment interdisciplinarily when needed.
Erectile dysfunction we treat in the Andrology section, where you will also find further information on hormone disorders and sexual problems.
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Urokompetenz – The Center for Urology
Klinik für Urologie und Urochirurgie der Clinic Bel Etage
Reichsstraße 59
40217 Düsseldorf