PAIN IN THE PENIS

Ask the Following Questions:

1. Is the pain mostly during micturition? If the pain is mostly during micturition, one should consider the possibilities of urethritis, cystitis, bladder calculus, prostatitis, urethral stricture, carcinoma of the bladder, seminal vesiculitis, anal fissure, and hemorrhoids.
2. If the pain is during micturition, is it mostly at the end of micturition? If the pain in the penis is at the end of micturition, chronic prostatitis, seminal vesiculitis, anal fissure, hemorrhoids, and bladder calculi should be suspected.
3. Is the pain mostly during an erection? If the pain is mostly during an erection, Peyronie's disease should be considered.
4. Is the pain unrelated to micturition or erection? If the pain is not related to micturition or erection, renal colic, epithelioma, appendicitis, anxiety, chancroid, and herpes simplex should be considered.
5. Is there a discharge? The presence of a urethral discharge should make one think of gonorrhea and nonspecific urethritis.

DIAGNOSTIC WORKUP

The most important diagnostic procedure is a urinalysis, urine culture and sensitivity, and smear and culture of any urethral discharge. It may be necessary to massage the prostate to obtain an adequate specimen! An intravenous pyelogram should be done if obstructive uropathy or bladder or renal calculi are suspected. If the above studies are negative, referral to a urologist should be made. He will probably do cystoscopy and retrograde pyelography as well as other diagnostic tests.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2008 Williams & Wilkins.

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More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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