What could be the cause of pain at the tip of the penis?
Patient's Query
Hello doctor,
I am a 49-year-old male, and for the past couple of weeks, I have been experiencing pain at the tip of my penis, which sometimes radiates to my genital area and pelvis. The pain is constant and throbbing, at about a six out of ten on the pain scale. There is also slight numbness but no discharge, foul smell, or visible abnormalities.
Over the past few years, I have had difficulty sitting, especially in chairs and on sofas, which has led me to read about pelvic floor dysfunction and pudendal neuralgia. The symptoms seem to match mine, as I can not sit for more than a few minutes without discomfort. I also have erectile dysfunction, but the medications I take for it work effectively.
I have tested negative for STIs, so I have ruled out infections. One theory I have is that this could be a temporary nerve issue. A couple of weeks ago, I engaged in rough oral sex and have also been masturbating more frequently than usual. I have read that such activities can irritate nerves, and I think it might just need time to heal. To help with this, I have decided to cut back on these activities and limit them to once a week to see if that helps. I had an MRI a couple of years ago, and my prostate looked fine, but I am due for another test soon.
Could you please advise on what might be causing this pain and numbness? Any recommendations on treatment or further tests would be greatly appreciated.
Please help me.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and understood it.
Based on the brief medical history and symptoms you have provided, I do not think the pain is caused by rough oral sex or masturbation. However, one thing I do not understand is why you are experiencing difficulty sitting on chairs or sofas. What could be the reason for this, and have you sought any medical help for it?
Sitting is a basic activity that most people do without trouble, so if sitting is difficult for you now or in the past, it is important to visit your nearby healthcare facility to determine the cause.
Do you have a history of pelvic pain, especially in the perineal and genital areas? How about urination symptoms? Do you experience any burning sensation or difficulty with urination? Do you have a history of renal stones (kidney stones)? Is the pain constant throughout the day, or does it occur only during specific situations? Have you undergone a urine examination or any laboratory tests related to your symptoms?
You definitely need a physical examination by your doctor to assess the possibility of nerve-related pain and to check for sensory symptoms. Medical investigations should be conducted accordingly.
I hope this has helped you.
Kindly follow up if you have more doubts.
Thank you.
Patient's Query
Hello doctor,
Thanks for your reply.
For the past few weeks, I have been experiencing constant, throbbing pain at the tip of the penis, occasionally radiating to the groin and pelvis, along with slight numbness and tingling. The symptoms worsen with sitting and improve with standing or using cushions, suggesting possible nerve involvement. There’s no burning during urination, no discharge, and recent tests for UTIs and STIs were negative. I have a history of erectile dysfunction, responsive to medication, and no known kidney stones. Given the longstanding difficulty with sitting and symptom pattern, I’m considering pudendal neuralgia or pelvic floor dysfunction. I’d like to know if further testing or specialist referral is appropriate.
Please help.
Hello,
Welcome to icliniq.com.
I don’t believe repeat STI testing is necessary at this point. However, a urine routine and microscopic examination would be advisable to rule out other possible causes. You've described pain localized around the tailbone, aggravated by prolonged sitting and radiating to the groin and penile area, without any lower urinary tract symptoms or other associated signs.
A few follow-up points to clarify:
-
Is the pain reproducible on palpation or pressure over the tailbone even when you're standing?
-
Do you have any history of recurrent episodes of acute prostatitis?
Given your symptoms, an MRI of the lower spine may be necessary to evaluate potential nerve-related issues. However, the need for imaging will be clearer after a clinical examination.
I recommend scheduling a video consultation so I can assess your symptoms in more detail and guide you appropriately on any required investigations.
Hope this helps.
Thank you.
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