Ultimate guide to PENIS HEALTH

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Male Sexual Problems

Couples today expect more out of sex and intimacy than in any point in history. As we live longer our expectations for conjugal bliss continue to grow, far

exceeding those of prior generations. Current divorce rates highlight how rarely our expectations are fulfilled. So if you are like most people you are having sexual difficulties or simply want better sex and intimacyyou will be interested in what follows. The good news is that men with sexual difficulties can anticipate more acceptance and better options than ever before. This has come about, in part, by women openly acknowledging their own sexual problems (e.g., lack of arousal and lubrication, difficulty reaching orgasm, low desire, and pain during sex). Likewise, more men today recognize the terrible burden of traditional male stereotypes. And more women refuse to silently endure years of frustrating and non-intimate sex the way their mothers did. For these and other reasons, couples today are increasingly open to new sexual information and/or consulting a therapist. Here is information about both:

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Mens Sexual Problems In the narrowest sense, male sexual difficulties involve getting or keeping an erection, ejaculating too rapidly, or difficulty reaching orgasm. What is hard enough, fast enough, and time enough (or

too long) is best decided by the people involved, rather than by a clock or some arbitrary standard. When you are deciding, keep the following in mind:

Most men experience difficulty with erections, rapid ejaculation, or delayed ejaculation at some time, and this is entirely normal. When it is frequent or pervasive, one partner or the other usually decides this is a "problem." Uneven sexual desire and dissimilar preferences in sexual style are normal and inevitable in long-term relationships. It is how you handle these that make the difference. Do not confuse the average guy with the Energizer Bunny. Many men have low sexual desire, too. Just like women, lots of men know what it is like to feel pressured by their spouses larger sexual appetite. Mens sexual difficulties usually decrease intimacy, too. When either partner has frequent dysfunction or low desire, both partners eventually retreat during sex into separate mental worlds of worry and frustration. Mind-reading during sex is not quite "the most intimate thing two people can do."

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Sexual Difficulties Are Normal You do not need sexual dysfunctions to fall into this, either. Sexual boredom, lack of intimacy, low desire, and passionless sex are common and inevitable developmentspotentially, mid-stages in the evolution of your relationship. Underneath common sexual difficulties, the natural processes of selfdevelopment are often playing out. While not enjoyable, they do not necessarily mean something is going, or has gone, wrong. Knowing this can help you relax and appreciate your relationship in new light. Actually, sexual difficulties can be "beneficial" if you heed them as a wakeup call: There is more to sex than removing inhibitions or learning new techniques, and a great many things cause sexual performance problems and low desire. Do not blame everything on "hang-ups," sexual incompatibility, or the signs of aging or disease. And do not reduce current sexual problems to things from the pastit may be the natural growth processes of your relationship at work in the present. To get the sex, intimacy, desire, and passion many of us want, there is a lot of growing up to do. Embarrassment is understandable but neither necessary nor helpful. Part of growing up involves addressing sexual difficulties like an adult. When men finally realize the real issue is not about sex, but rather, about whether they will continue to apologize for themselves, they often step forward as acts of personal integrity. At its best, resolving sexual difficulties helps both partners see themselves and each other in some new way. This process deepens your capacity for intimacy and strengthens your bonds of love. Sexual "problems" can turn out to be odd blessings. When things finally become insurmountable and intolerable, some couples seek a therapist who helps them have better sex, intimacy, and a better relationship than they had before their "problem." Some of my own clients, initially embarrassed about seeing a therapist, proudly revealed what they learned to a trusted friend or a valued grown child.

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Treatment Options Men with sexual difficulties in prior generations had fewer options available. Treating erection problems with surgically inserted silicone rods, vacuum pumps, and injecting drugs into your penis left much to be desired. Early versions of sex therapy seemed mechanical and technique-oriented to many couples, too. Today, erection difficulties, rapid ejaculation, delayed ejaculation, and low desire are all treatable problems. Advances in intimacy-based sex-and-relationship therapy and more convenient medicines, like Viagra, offer far more effective and pleasant solutions than ever before. Even now, new medical miracles are on the horizon. But better genital function alone will not solve problems lying dormant in your relationship. There can still be some relationship repair to do. When to Get Help You probably do not have to worry about seeking help prematurelythe overwhelming tendency is to struggle along in secrecy for as long as possible. If things do not seem to be getting better, a marriage and family therapist can often be of help (especially one trained in treating sexual difficulties). It is always appropriate to consult your physician for a medical evaluation, too. Therapists can collaborate with physicians when medical treatment is indicated. Parents Sexual Relationship is a Family Matter. Parents sexual relationships are and should be private, but their impacts on their familiesboth bad and goodnever are. Imagine a man who struggles with rapid ejaculation, or erectile difficulty, or decreasing sexual desire. Ask yourself: Is he more likely to over-react to normal authority challenges from his adolescent son, or to downturns in his income, or to his wife starting a new career? Children monitor their parents relationship with a hawk-eye. Lack of affection between Mom and Dad is as big an event as walking in on them smooching. When parents have a solid emotional and physical relationship, the household ambiance makes everyone more available to each other. Kids may complain about parents getting "mushy," but they are being blessed with a wonderful template that serves well in later life.

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ERECTILE DYSFUNCTION
What is erectile dysfunction (ED)?

ED is the inability to get or keep an erection firm enough for sexual intercourse. ED can be a total inability to achieve an erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. ED is sometimes called impotence, but that word is being used less often so that it will not be confused with other, nonmedical meanings of the term.

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The National Institutes of Health estimates that ED affects as many as 30 million men in the United States. Incidence increases with age: About 4 percent of men in their 50s and nearly 17 percent of men in their 60s experience a total inability to achieve an erection. The incidence jumps to 47 percent for men older than 75. But ED is not an inevitable part of aging. ED is treatable at any age.

Click here to get Natural ROCK- HARD ERECTION How does an erection occur?

Two chambers called the corpora cavernosa run the length of the penis (see Figure 1). A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the corpus spongiosum.

An erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in through the arteries and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining the erection. The erection ends when muscles in the penis contract to stop the inflow of blood and open the veins for blood outflow.

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Figure 1. Arteries and veins of the penis

What causes ED?

ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Because an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa. Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of ED. Diseases-such as diabetes, high blood pressure, nerve

disease or nerve damage, multiple sclerosis, atherosclerosis, and heart disease-account for the majority of ED cases. Patients should be thoroughly evaluated for these conditions before they begin any form of treatment for ED. Lifestyle choices that contribute to heart disease and vascular problems also raise the risk of ED. Smoking, drinking alcohol excessively, being overweight, and not exercising are possible causes of ED. Surgery-especially radical prostate and bladder surgery for cancer-can also injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and the fibrous tissues of the corpora cavernosa. In addition, ED can be a side effect of many common medicines such as blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine, an ulcer drug. Psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure can also cause ED. Even when ED has a physical cause, psychological factors may make the condition worse. Hormonal abnormalities, such as low levels of testosterone, are a less frequent cause of ED.

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How is ED diagnosed?

Patient History A person's medical and sexual histories help define the degree and nature of ED. The medical history can disclose diseases that lead to ED, and a simple recounting of sexual activity might identify problems with sexual desire, erection, ejaculation, or orgasm. Use of certain prescription or illegal drugs can suggest a chemical cause because drug effects are a frequent cause of ED. Physical Examination A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to physical touch, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as unusual hair pattern or breast enlargement, can point to hormonal problems, which would mean the endocrine system is involved. The doctor might discover a circulatory problem by observing decreased pulses in the wrist or ankles. And unusual characteristics of the penis itself could suggest the source of the problem-for example, a penis that bends or curves when erect could be the result of Peyronies disease.

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Laboratory Tests Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of available testosterone in the blood can yield information about problems with the endocrine system and may explain why a patient has decreased sexual desire. Other Tests Monitoring erections that occur during sleep-nocturnal erections-can help rule out certain psychological causes of ED. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is likely to have a physical rather than a psychological cause. Tests for nocturnal erections are not completely reliable, however. Scientists have not standardized such tests and have not determined when they should be conducted for best results.
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Psychosocial Examination A psychosocial examination, using an interview and a questionnaire, can reveal psychological factors. A man's sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse.

How is ED treated?

Most doctors suggest that treatments proceed from least to most invasive. Making a few healthy lifestyle changes may solve the problem. Quitting smoking, reducing alcohol consumption, losing excess weight, and increasing physical activity may help some men regain sexual function. Cutting back on or replacing medicines that could be causing ED is considered next. For example, if a patient thinks a particular blood pressure medicine is causing problems with erection, he should tell his doctor and ask whether he can try a different class of blood pressure medicine. Psychotherapy and behaviour modifications in selected patients are considered next if indicated, followed by oral or locally injected drugs, vacuum devices, and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered.

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Psychotherapy Experts often treat psychologically based ED using techniques that decrease the anxiety associated with intercourse. The patient's partner can help with the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety during treatment for ED from physical causes. Drug Therapy Drugs for treating ED can be taken orally, injected directly into the penis, or inserted into the urethra at the tip of the penis.

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Oral Medications In March 1998, the U.S. Food and Drug Administration (FDA) approved sildenafil (Viagra), the first pill to treat ED. Since that time, vardenafil hydrochloride (Levitra) and tadalafil (Cialis) have also been approved. Additional oral medicines are being tested for safety and effectiveness.

Viagra, Levitra, and Cialis all belong to a class of drugs called phosphodiesterase (PDE) inhibitors. Taken an hour before sexual activity, these drugs work by enhancing the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow. The recommended dose for Viagra is 50 milligrams (mg), and the doctor may adjust this dose to 100 mg or 25 mg, depending on the patient. The recommended dose for either Levitra or Cialis is 10 mg, and the doctor may adjust this dose to 20 mg if 10 mg is insufficient. Lower doses of 5 mg and 2.5 mg are available for patients who take other medicines or have conditions that may decrease the body's ability to use the drug. The 5 mg and 2.5 mg doses of Cialis are FDA-approved for daily use. None of these PDE inhibitors should be used more than once a day. Men who take nitratebased drugs such as nitroglycerin pills for heart problems should not use any of the three drugs because the combination can cause a sudden drop in blood pressure. Also, men should tell their doctor if they take any drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure. The doctor may need to adjust the ED prescription. Taking a PDE inhibitor and an alpha-blocker within 4 hours of each other can cause a sudden drop in blood pressure. A small number of men have experienced vision or hearing loss after taking a PDE inhibitor. Men who experience vision or hearing loss should seek prompt medical attention. Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage. Patients also have claimed that other oral drugs-including yohimbine hydrochloride, dopamine and serotonin agonists, and trazodoneare effective, but the results of scientific studies to substantiate these claims have been inconsistent. Improvements observed following use of these drugs may be examples of the placebo effect-that is, a change that results simply from the patients belief that an improvement will occur.
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Injectable Medications While oral medicines improve the response to sexual stimulation, they do not trigger an automatic erection as injections do. Many men achieve stronger erections by injecting drugs into the penis, causing it to become engorged with blood. Drugs such as papaverine hydrochloride, phentolamine, and alprostadil widen blood vessels. The injectable form of alprostadil is marketed as Caverject. These drugs may create unwanted side effects, however, including scarring of the penis and persistent erection, known as priapism. Nitroglycerin ointment, a muscle relaxant, can sometimes enhance an erection when rubbed on the penis. A system for inserting a pellet of alprostadil into the urethra uses a prefilled applicator to deliver the pellet about an inch into the urethra. The pellet form of alprostadil is marketed as MUSE. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes. The most common side effects are aching in the penis, testicles, and area between the penis and rectum; a warm or burning sensation in the urethra; redness from increased blood flow to the penis; and minor urethral bleeding or spotting.

Research on drugs for treating ED is expanding rapidly. Patients should ask their doctor about the latest advances.
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Vacuum Devices Mechanical vacuum devices cause an erection by creating a partial vacuum, which draws blood into the corpora cavernosa, engorging and expanding the penis. The devices have three components: a plastic cylinder, into which the penis is placed; a pump, which draws air out of the cylinder; and an elastic ring, which is moved from the end of the cylinder to the base of the penis as the cylinder is removed. The elastic ring maintains the erection during intercourse by preventing blood from flowing back into the body (see Figure 2). The elastic ring can remain in place up to 30 minutes. The ring should be removed after that time to restore normal circulation and to avoid skin irritation.

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Couples may find that using a vacuum device requires some practice or adjustment. An erection achieved with a vacuum device may not feel like an erection achieved naturally. The penis may feel cold or numb and have a purple colour. Bruising on the shaft of the penis may occur, but the bruises are usually painless and disappear in a few days. Ejaculation may be weakened because the elastic ring blocks some of the semen from travelling through the urethra, but the pleasure of orgasm is usually not affected. Figure 2. Vacuum device

A vacuum device causes an erection by creating a partial vacuum around the penis, which draws blood into the corpora cavernosa.

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Surgery Surgery usually has one of three goals:

to implant a device that can cause the penis to become erect to reconstruct arteries to increase blood flow to the penis to block off veins that allow blood to leak from the penile tissues

Implanted devices, known as prostheses, can restore erection in many men with ED. Malleable implants usually consist of paired rods, which are inserted surgically into the corpora cavernosa. The user manually adjusts the position of the penis and, therefore, the rods. Adjustment does not affect the width or length of the penis. Inflatable implants consist of paired cylinders, which are surgically inserted inside the penis and can be expanded using pressurized fluid (see Figure 3). Tubes connect the cylinders to a fluid reservoir and a pump, which are also surgically implanted. The patient inflates the cylinders by pressing on the small pump, located under the skin in the scrotum. The pump causes fluid to flow from a reservoir residing in the lower pelvis to two cylinders residing in the penis. Inflatable implants can expand the length and width of the penis to some degree. They also leave the penis in a more natural state than malleable implants do when not inflated. Once a man has either a malleable or inflatable implant, he must use the device to have an erection. Possible problems with implants include mechanical breakdown and infection, although mechanical problems have decreased in recent years because of technological advances.

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Figure 3. Surgical implant

With an inflatable implant, an erection is produced by squeezing a small pump implanted in the scrotum. The cylinders expand to create the erection. Surgery to repair arteries can reduce ED caused by obstructions that block the flow of blood. The best candidates for such surgery are young men with discrete blockage of an artery because of an injury to the groin or fracture of the pelvis. The procedure is usually unsuccessful in older men with widespread blockage. Surgery to veins that allow blood to leave the penis usually involves an opposite procedureintentional blockage. Blocking off veins, called ligation, can reduce the leakage of blood that diminishes the rigidity of the penis during an erection. However, experts have raised questions about the long-term effectiveness of this procedure, and it is rarely done.

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Premature ejaculation occurs when a man has an orgasm sooner during intercourse than he or his partner wishes.

Causes
Premature ejaculation is a common complaint. It is only rarely caused by a physical problem. Premature ejaculation early in a relationship is most often caused by anxiety and too much stimulation. Guilt and other psychological factors may also be involved. The condition usually improves without treatment.

Symptoms
The man ejaculates before he or his partner would like (prematurely). This may range from before penetration to a point just after penetration. It may leave the couple feeling unsatisfied.

Exams and Tests

There usually are no abnormal findings with the condition. The health care provider can get more useful information from interviewing the person or couple. Click here to get your PREMATURE EJACULATION PILLS AND STAY 10 TIMES LONGER IN BED

Treatment
Practice and relaxation should help you deal with the problem. Some men try to distract themselves by thinking nonsexual thoughts (such as naming baseball players and records) to avoid getting excited too fast. There are several helpful techniques you can try. The "stop and start" method:

This technique involves sexually stimulating the man until he feels like he is about to reach orgasm. Stop the stimulation for about 30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.

The "squeeze" method:

This technique involves sexually stimulating the man until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds. Stop sexual stimulation for about 30 seconds, and then start it again. The person or couple may repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.

Antidepressants such as Prozac and other selective serotonin reuptake inhibitors (SSRIs) may be helpful because one of their side effects is to prolong the time it takes to reach ejaculation. You can apply a local anaesthetic cream to the penis to reduce stimulation. Decreased feeling in the penis may delay ejaculation. Condom use may also have this effect for some men. If these distraction techniques cause difficulty maintaining an erection, medications used for erectile dysfunction may help. Evaluation by a sex therapist, psychologist, or psychiatrist may help some couples.

Outlook (Prognosis)
In most cases, the man is able to learn how to control ejaculation through education and by practicing the simple techniques outlined. Chronic premature ejaculation may be a sign of anxiety or depression. A psychiatrist or psychologist can help treat these conditions.

Possible Complications

Very early ejaculation, before the man is able to enter the vagina, may prevent a couple from achieving a pregnancy. A continued lack of control over ejaculation may cause one or both partners to feel sexually dissatisfied. It may be lead to sexual tension or discord in the relationship.

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Disorders of the 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 mans sexual functioning and fertility.

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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 Anaesthesia Penile injection therapy (a treatment for erectile dysfunction) Blood diseases, including leukaemia and sickle cell anaemia

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.

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Peyronies 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, Peyronies disease can cause general pain as well as painful erections. It also can cause emotional distress, and affect a mans 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 Peyronies disease, however, develop slowly and are severe enough to require surgical treatment. Other possible causes of Peyronies disease include:

Vasculitis This is an inflammation of blood or lymphatic vessels. This inflammation can lead to the formation of scar tissue. Connective tissue disorders According to the National Institutes of Health, about 30 percent of men with Peyronies disease also develop disorders that affect the connective tissue in other parts of their bodies. These disorders generally cause a thickening or hardening of the connective tissue. Connective tissue is specialized tissuesuch as cartilage, bone and skinthat acts to support other body tissues. Heredity Some studies suggest that a man who has a relative with Peyronies disease is at greater risk for developing the disease himself.

Because the plaque of Peyronie's disease often shrinks or disappears without treatment, most doctors suggest waiting one to two years or longer before attempting to correct it with surgery. In many cases, surgery produces positive results. But because complications can occur, and because many of the problems associated with Peyronie's disease (for example, shortening of the penis) are not corrected by surgery, most doctors prefer to perform surgery only on men with curvatures so severe that sexual intercourse is impossible. There are two surgical techniques used to treat Peyronies disease. One method involves the removal of the plaque followed by placement of a patch of skin or artificial material (skin graft). With the second technique, the surgeon removes or pinches the tissue from the side of the penis opposite the plaque, which cancels out the bending effect. The first method can involve partial loss of erectile function, especially rigidity. The second method, known as the Nesbit procedure, causes a shortening of the erect penis. A non-surgical treatment for Peyronies disease involves injecting medication directly into the plaque in an attempt to soften the affected tissue, decrease the pain and correct the

curvature of the penis. Penile implants can be used in cases where Peyronies disease has affected the mans ability to achieve or maintain an erection.

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Balanitis

Balanitis is an inflammation of the skin covering the head of the penis. A similar condition, balanoposthitis, refers to inflammation of the head and the foreskin. Symptoms of balanitis include redness or swelling, itching, rash, pain and a foul-smelling discharge. Balanitis most often occurs in men and boys who have not been circumcised (had their foreskin surgically removed), and who have poor hygiene. Inflammation can occur if the sensitive skin under the foreskin is not washed regularly, allowing sweat, debris, dead skin and bacteria to collect under the foreskin and cause irritation. The presence of tight foreskin may make it difficult to keep this area clean and can lead to irritation by a foul-smelling substance (smegma) that can accumulate under the foreskin. Other causes may include:

Dermatitis/allergy Dermatitis is an inflammation of the skin, often caused by an irritating substance or a contact allergy. Sensitivity to chemicals in certain productssuch as soaps, detergents, perfumes and spermicidescan cause an allergic reaction, including irritation, itching and a rash. Infection Infection with the yeast candida albicans (thrush) can result in an itchy, spotty rash. Certain sexually transmitted diseasesincluding gonorrhea, herpes and syphiliscan produce symptoms of balanitis.

In addition, men with diabetes are at greater risk for balanitis. Glucose (sugar) in the urine that is trapped under the foreskin serves as a breeding ground for bacteria. Persistent inflammation of the penis head and foreskin can result in scarring, which can cause a tightening of the foreskin (phimosis) and a narrowing of the urethra (tube that drains urine from the bladder). Inflammation also can lead to swelling of the foreskin, which can cause injury to the penis. Treatment for balanitis depends on the underlying cause. If there is an infection, treatment will include an appropriate antibiotic or antifungal medication. In cases of severe or persistent inflammation, a circumcision may be recommended. Taking appropriate hygiene measures can help prevent future bouts of balanitis. In addition, it is important to avoid strong soaps or chemicals, especially those known to cause a skin reaction.

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Phimosis and paraphimosis

Phimosis is a condition in which the foreskin of the penis is so tight that it cannot be pulled back (retracted) to reveal the head of the penis. Paraphimosis occurs when the foreskin, once retracted, cannot return to its original location. Phimosis, which is seen most often in children, may be present at birth. It also can be caused by an infection, or by scar tissue that formed as a result of injury or chronic inflammation. Another cause of phimosis is balanitis, which leads to scarring and tightness of the foreskin. Immediate medical attention is necessary if the condition makes urination difficult or impossible. Paraphimosis is a medical emergency that can cause serious complications if not treated. Paraphimosis may occur after an erection or sexual activity or as the result of injury to the head of the penis. With paraphimosis, the foreskin becomes stuck behind the ridge of the head of the penis. If this condition is prolonged, it can cause pain and swelling, and impair blood flow to the penis. In extreme cases, the lack of blood flow can result in the death of tissue (gangrene), and amputation of the penis may be necessary. Treatment of phimosis may include gentle, manual stretching of the foreskin over a period of time. Sometimes, the foreskin can be loosened with medication applied to the penis. Circumcision, the surgical removal of the foreskin, often is used to treat phimosis. Another surgical procedure, called preputioplasty, involves separating the foreskin from the glans. This procedure preserves the foreskin and is less traumatic than circumcision. Treatment of paraphimosis focuses on reducing the swelling of the glans and foreskin. Applying ice may help reduce swelling, as may applying pressure to the glans to force out blood and fluid. If these measures fail to reduce swelling and allow the foreskin to return to its normal position, an injection of medication to help drain the penis may be necessary. In severe cases, a surgeon may make small cuts in the foreskin to release it. Circumcision also may be used as a treatment for paraphimosis.
Penile cancer

A rare form of cancer, penile cancer occurs when abnormal cells in the penis divide and grow uncontrolled. Certain benign (non-cancerous) tumors may progress and become cancer. The exact cause of penile cancer is not known, but there are certain risk factors for the disease. A risk factor is anything that increases a persons chance of getting a disease. The risk factors for cancer of the penis may include the following:

CircumcisionMen who are not circumcised at birth have a higher risk for getting cancer of the penis. Human papillomavirus (HPV) infectionHPVs are a group of more than 70 types of viruses that can cause warts (papillomas). Certain types of HPVs can infect the reproductive organs and the anal area. These types of HPVs are passed from one person to another during sexual contact. SmokingSmoking exposes the body to many cancer-causing chemicals that affect more than the lungs. SmegmaOily secretions from the skin can accumulate under the foreskin of the penis. The result is a thick, bad-smelling substance called smegma. If the penis is not cleaned thoroughly, the presence of smegma can cause irritation and inflammation. PhimosisThis is a condition in which the foreskin becomes constricted and difficult to retract. Treatment for psoriasisThe skin disease psoriasis is sometimes treated with a combination of medication and exposure to ultraviolet light. AgeMost cases of penile cancer occur in men over age 50.

Symptoms of penile cancer include growths or sores on the penis, abnormal discharge from the penis and bleeding. Surgery to remove the cancer is the most common treatment for penile cancer. A doctor may take out the cancer using one of the following operations:

Wide local excision takes out only the cancer and some normal tissue on either side. Microsurgery is an operation that removes the cancer and as little normal tissue as possible. During this surgery, the doctor uses a microscope to look at the cancerous area to make sure all the cancer cells are removed. Laser surgery uses a narrow beam of light to remove cancer cells. Circumcision is an operation that removes the foreskin. Amputation of the penis (penectomy) is an operation that removes the penis. It is the most common and most effective treatment of cancer of the penis. In a partial penectomy, part of the penis is removed. In a total penectomy, the whole penis is removed. Lymph nodes in the groin may be taken out during surgery.

Radiation, which uses high-energy rays to attack cancer, and chemotherapy, which uses drugs to kill cancer, are other treatment options.

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