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Q. What causes smelly penis with erection problem and lack of interest in sex?

Answered by
Dr. Devendra
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Apr 17, 2019

Hello doctor,

I have a smelly penis issue, and erection problems, no interest in sex, and that happened two years back. The doctors just checked for all UTIs but found nothing. I wonder if the issue is related to fungus infection. All checks are done even bladder and MRI nothing is showing, but the smell is there like the inside of bicycle tires rubber 24*7. It never goes away. And the doctors are beginning to think I am hypochondriac. Which is not the case.

I have had a strong depression two years back due to difficult master program, from that time, my sex drive dropped in half and I do not find that I need sex anymore, it is more planned, I started to use Viagra, and I feel sex is more duty towards my wife and not something I really want. Please help.

Dr. Devendra

Urology
#

Hi,

Welcome to icliniq.com.

Every male has a typical pheromone causing smell characteristic of each male. Are you circumcised? Any urinary symptoms except occasional dysuria. How many times do you get up at night to void? Microscopic hematuria on how many occasions? Kindly share the urine R/M report. Can you achieve an erection on sexual stimulation or early morning?


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Thank you doctor,

I do not have the extra skin, NVH is every time they check my urine, they find nonvisible blood, while no fever, kidney function is alright. They checked with scope in bladder- Nothing. I did an MRI one year back nothing either, however, I got a spermatocele which was deemed benign, from that time and my sexual appetite is almost zero. I do get morning erections sometimes not always. And ejaculation does not feel like before either, the smell is always there around the penis. No, I do not urinate unvolunteeringly, and no discharge.

Just smell, low sexual appetite, and non-visible haematuria, sometimes four and sometimes five in the urine test. All blood test seems to be normal. But I am lethargic all the time. I met with my doctors today, they will take a swab from the penis area to check after two days and then scheduled for CT scan. Can a spermatocele on left side cause any of the issues above, and does candida in men cause smell? What can be the issue?

Dr. Devendra

Urology
#

Hi,

Welcome back to icliniq.com.

1. Since you are circumcised and no symptoms relating to urethral discharge, very unlikely to find any urologic pathology to target treatment for the smell.

2. You have no symptoms related to the size of spermatoceles like excessive lump or pain. That finding also does not have a bearing on any of your symptoms.

3. Microscopic hematuria on multiple occasions needs evaluation. For this cystoscopy has been already done. If CT also does not show anything: will need a repeat follow-up later at 3 to 6 months by urine analysis or USG KUB region. Physiologic haematuria is also common after strenous exercise. RBC morphology will surely rule out glomerular bleed (bleed from kidney or leakage from sieve).

4. Candidal infection of the urinary system in a healthy circumcised male is unlikely and does not give rise to smell.

5. Smell in urine can have many sources (no infection in your case as no significant number of pus cells). Diet content, metabolic abnormality leading to excretion of some waste products in the urine causing smell. That is to be treated by the physician instead of a urologist. Infrequent ejaculation may also cause inflammation in prostate leading to RBC in urine and smell in urethral secretions.

6. Low sexual desire is also multifactorial. If you have good occasional morning erection, normal range testosterone values- You do not need medical treatment rather Yoga will help. Counseling is very important to address this issue at your age to understand your expectations and symptoms better.


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