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Q. There is a black mass on my penile shaft seen when the foreskin is pulled down. Please help.

Answered by
Dr. Raveendran Sr
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Oct 24, 2020 and last reviewed on: Mar 18, 2021

Hi doctor,

Halfway down my penile shaft, I seem to have a black mass. I can notice it only when my foreskin is pulled down. I have symptoms of prostatitis and urethritis for two years. I have symptoms of dysuria, urine dribbling, inflamed meatus, constant urethral pain, prostatitis, epididymitis and urethral stricture. I have consulted many specialists and taken all tests for STD. I am going to do a semen analysis soon. Can I have this black mass due to peyronie's disease? I have never experienced any curvature or direct shrinkage. But I have weakness, poor erection, urinary retention, dysuria and painful orgasm. I need some help. I have taken some countless antibiotics like Doxycycline, Ciprofloxacin, Metronidazole and Azithromycin to treat my condition. My urologist suspect it as a cause of discomfort and urine dribbling.

#

Hi,

Welcome to icliniq.com.

I understand your concern. You have taken a lot of antibiotics to get cured. If it is a prostate infection, then it takes some time to get cured. If you have pain during ejaculation, then you need think of a bacterial infection. You have done some investigations for STD (sexually transmitted disease) already. I have gone through the attached picture (attachment removed to protect patient identity). You have a small elevated black spot. You need a small surgical procedure to remove it. Swelling can occur due to folliculitis. If you have pain, you need to do remove it and get tested. If it is painless, then measure its size every week and check for any increase in size. If there is no change, then there is nothing to be worried. Do a urine culture with semen culture and check for infection. Please do an ultrasound and CT (computed tomography) of abdomen soon. Consult a urologist to treat the condition.


The Probable causes:

You have UTI (urinary tract infection) or prostatitis.

Investigations to be done:

You need to do urine culture and semen culture. Do an ultrasound or CT (computed tomography) abdomen soon.

Differential diagnosis:

You seem to have UTI (urinary tract infection) and prostatitis.

Treatment plan:

You need medical management.

Regarding follow up:

Have a follow-up with reports.

Thank you doctor,

I have done my urine culture and it showed an increase in the level of WBC. I am planning to do my semen culture. I have done two cystoscopies before a year and it showed a prostate inflammation. The other one showed a urethral stricture. I have urinary diversion with a collection of urine stuck in my meatus. After that, it dribbles in the lower head of the penis. I thought that my symptoms are due to lichen sclerosis infection and it showed in me before two years. I have got an infection with Epstein-Barr virus. Before three years, I had balanitis on the penis shaft. It got cleared after I cleaned it with alcohol swab pad. I know that this can be a sign of primary mycoplasma infection. I need your help. I feel like I have a pen cap in my penis. I want some relief. I have consulted many doctors and they failed to give me a diagnosis. Please suggest.

#

Hi,

Welcome back to icliniq.com.

You need to consult a urologist to review your issue. We can consider your issue as infection when the WBC (white blood cells) is more than 4 to 5. Try to restrain from sex for a week. If you have tenderness with inflammation, then it can be caused due to infection. You can do a prostate massage with the help of the urologist. If you have pain during urination, then it can due to urethral stricture. You need to consult a experienced urologist to remove it. Epstein-Barr virus occurs rarely in these issues. Balanitis occurs due to fungal infection and it can be treated easily. You can try doing prostate massage and get your culture report soon.


Regarding follow up:

Have a review with your reports.

Thank you doctor,

I will get the results of my semen culture soon. I have sudden intense pain while urinating. I have done my urine analysis and it showed a bacteria. I am restraining from sex for a week. Do I need to wait for a week to do prostate massage? Can I do them at the same time?

#

Hi,

Welcome back to icliniq.com.

After getting the reports, kindly share it. You can use a urine alkaniser for getting symptomatic relief. Try to refrain away from sex for a week. You need to void urine before having massage. There is no relation present between prostate massage and infection. You can do it any time.


Treatment plan:

You need a medical management.

Regarding follow up:

Have a review with reports.

Thank you doctor,

I am experiencing meatal stenosis. I have a swollen shut in the lower one third of the meatus and it catches my urine that dribbles on the head of the penis. This catching of urine causes the urine to void in a V shape. I have lower back pain. I have a urethral stricture with symptoms of prostatitis and urine dribbling. My uncle had this problem when he was kid. I have attached my picture and kindly go through it. I think that dribbling causes chronic inflammation. Could a meatal stenosis cause urethral stenosis?

#

Hi,

Welcome back to icliniq.com.

I can able to see a small swelling. You can have it due to urethral stricture. If you have lower back pain due to kidneys, then start taking antibiotics and do prostate massage for prostate issue. You can have urethral stricture due to some physical issue that can cause changes in the flow of the urine.


The Probable causes:

You can have UTI or prostatitis.

Investigations to be done:

Do a urine culture and semen culture soon and check for infection. Do an ultrasound abdomen and CT (computed tomography).

Differential diagnosis:

You can have UTI or prostatitis.

Probable diagnosis:

You can have UTI or prostatitis.

Treatment plan:

You need a medical management.

Regarding follow up:

Have a review with reports.


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