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I get pain in my penis during erection and burning during urination. Why?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At December 2, 2020
Reviewed AtJanuary 5, 2024

Patient's Query

Hello doctor,

About three months ago, I started getting pain in my penis when erect, and a burning sensation was there for a week when I urinated. I went to the doctor, who sent me for urine tests, where blood was found in my urine. So they sent me for three further urine tests, 24 hours apart, where one out of three had blood. They also tested for cancer, which came back negative. The burning went away, so I went for a further urine test, which was clear. I did an abdominal ultrasound sound, which did not show a problem with my bladder. However, I still have pain when I get an erection, a weak erection, and low libido. Could this be prostrate cancer?

Thanks.

Hi,

Welcome to icliniq.com.

I understand your concern.

Pain in erection or burning urinating in the long term indicates chronic prostate inflammation. It is scarce to have prostate cancer at this age. Bladder cancer symptoms are painless and asymptomatic hematuria. For proper diagnosis, we need semen for culture and choose the appropriate antibiotic, which is necessary for the long term, about six weeks, as antibiotics penetrate the prostatic capsule slowly and require time to treat prostatitis. Please follow up with semen culture results to give you a proper antibiotic. Please note chronic prostatitis can be bacterial or without bacteria. If the culture is negative, I will start you on different medications. Therefore follow-up is essential.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thank you for the reply.

I recently went for a semen test for fertility. I am not sure if that would show bacteria. I did a urine test for cancer, and it was negative. Could that be for prostrate as well? Should this be an infection?

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

The semen for fertility is not the same for culture. Both are different tests. The urine test for cancer is for bladder and urinary tract cancer, not prostate cancer. Before the age of 50, prostate cancer is sporadic. The test for prostate cancer is a blood test called PSA (prostate-specific antigen), but we screen it for people who are above 50 years. And as well mentioned earlier, prostate cancer is painless.

I hope this information will help you.

Thanks.

Patient's Query

Hello doctor,

Thanks for the reply.

Today, I went for a check-up at a local urologist. He did a penis and prostrate examination and concluded that I had scar tissue under my penis, which was causing weak erections and painful erections. Quite a few things did not add up, so I am requesting a second opinion. However, I wanted to know how I know if I have plaque buildup on the penis shaft. Is there a cure, or what is the course of treatment? Is it life-threatening, or will it shorten my life span? What is the prognosis? Does this mean there is a potential I would not be able to have intercourse again? Please help.

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Fibrotic plaque on the penile shaft is called Peyronie’s disease. It forms on the rigid layer of the penis, called the tunica albuginea, and on examination, you can feel hardness profound on the penis at that affected area. It starts with a painful and inflamed area and stabilizes after a few months up to six months to form fibrotic plaque. That leads to painless erection and curvature of the penis on erection to variable degrees depending on the extent of fibrosis. This condition can be treated depending on the degree of curvature. Treatment varies from injections to shockwaves to surgery. We need pictures of your penis in a flaccid, erect state for diagnosis. Answering your queries is not at all life-threatening or affects your life span. The prognosis depends on the degree of curvature and amount of fibrosis, which will be assessed by examination and pictures, then can offer you treatment and estimate the outcome. Regarding potency after treatment again, it depends on treatment. If injections or shockwaves occur, then erection can be preserved well. Surgical treatment must be done in specialized centers to give you the best results.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thank you for your reply.

  1. Once the plaque has fully formed, does the pain disappear when a person gets an erection?
  2. Is there any erectile dysfunction associated with this problem?
  3. In your opinion, is the treatment available effective?
  4. What does Peyronie’s disease look like?

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Once the plaque has formed and stabilized, no more pain should occur. The only issue will be with the deformity. The treatment depends on the degree of deformation or curvature. If it is less than 45 degrees, then there is no surgical treatment, and some patients opt for collagenase injections or shock wave therapy, which is usually adequate. Peyronie’s disease can have less or no curvature as the main feature is fibrosis which you can feel on the penis when you palpate it. The rest of the penis will be soft, and that area will be hard.

I hope this information will help you.

Thanks.

Patient's Query

Hello doctor,

Thanks for the reply. Can you review my abdominal ultrasound? I wanted to know if I have a healthy liver and everything else is good.

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

I reviewed the ultrasound (attachments removed to protect the patient's identity). You have the right three millimeters renal stone, which only requires hydration of three liters of water daily, with no other intervention. Another thing is that your liver shows some changes, requiring a liver function test and review with a hepatologist or internal medicine doctor. This liver function test is called serum LFT. After the result, make an appointment with an internal medicine doctor or gastroenterologist doctor for a follow-up regarding the liver.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thanks for the reply.

Will the cyst go away? What is wrong with my liver? Can it be fixed? I had a liver function test a few months ago. Please help.

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.I asked to refer to gastroenterologist because I am not specialized in liver but in kidney. I hope this information will help you.

Thanks.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Samer Sameer Juma Ali Altawil
Dr. Samer Sameer Juma Ali Altawil

Urology

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