Causes of pain in the middle of the penis and available treatments.

Men feel anxious when experiencing pain in the middle of the penis, as they fear that it is a sign of a disease. The "Dalili Medical" website reviews in this report the causes of pain in this area.

**What is penis pain?**
Penis pain is a feeling of pain in the male genital organ, which contains the urethra (urethra). This pain can affect the foreskin (part of the penis), the base of the penis, or the head. The pain is often accompanied by burning and itching, in addition to difficulty urinating and blood in the urine. Urinary tract infections may be the cause of this pain, and it can also be the result of an accident. This type of pain affects men of all ages, and its severity varies from mild to severe. In all cases, attention should be paid to any pain in the penis, especially if it is accompanied by a painful erection, sores, redness, or swelling.

**Symptoms of mid-penis pain**
A man may suffer from additional symptoms in addition to pain in the middle of the penis, including:
- Swelling of the tip of the penis (foreskin).
- Redness and irritation of the penis.
- Itching.
- Burning during urination.
- Abnormal discharge from the penis.
- Discoloration or cloudiness of urine.
- Pain during or after sex.
- Blisters or sores on the shaft of the penis.

**Penis Components**
The penis consists of the following parts:
- **Head or glans**: This is where semen and urine come out.
- **Penis shaft**: The longer part that extends from the head to the lower abdomen.
- **Foreskin**: The retractable skin that covers the head of the penis, and may be surgically removed in some cases.
- **Frenum**: The area where the foreskin meets the underside of the penis.

**When should you see a doctor?**
You should seek immediate treatment for penis pain in the emergency room if you have:
- Painful erection that lasts 3 to 4 hours.
- Severe difficulty urinating.
- A strong blow to the groin from an accident or sports injury.
- A broken penis.

**Causes of Pain in the Middle of the Penis**

**Penis Fracture**

Although there are no bones in the penis, it can break when the erect penis is bent, causing a tear in its tissue. These fractures often occur during sex. Symptoms associated with a penile fracture include:
- A popping sound.

- Sudden loss of erection.

- Bruising and swelling of the penis.

- Bleeding from the penis.

- Blood in the urine.

- Pain.

- Difficulty urinating.

Anyone who suffers a penile fracture requires urgent medical attention and may need surgery to drain the blood and repair damaged tissue.

**Peyronie's Disease**

Peyronie's disease occurs when scar tissue forms in the penis, causing pain, often in the middle of the penis. The exact cause of this condition is still unclear, but it is thought to be related to autoimmune diseases.

**Urinary tract infection**

If the bacterial infection causing UTI is concentrated in the bladder and urethra, a man may feel pain in the shaft of the penis. Penile pain becomes a clear sign of a UTI if it is accompanied by:
- Burning during urination.

- Frequent urination.

- Decreased urine output.

- Blood in the urine.

- Foul-smelling urine.

- Pain near the anus.

**Balanitis**

Balanitis, which affects the head of the penis, can extend to the upper or middle part of the penis, causing pain, itching, and abnormal discharge.

**Penile cancer**

If a man has the following symptoms and is experiencing pain in the middle of the penis, this may be an indication of penile cancer:

- An abnormal lump in the shaft of the penis.

- Redness of the penis.

- Swelling of the penis.

- Itching of the penis.

- Abnormal discharge from the penis.

- Burning sensation inside the penis.

- Change in the color or thickness of the skin of the penis.

- Appearance of blood or semen in the urine.

**Priapism**

A condition that causes the penis to remain erect for more than 4 hours, and its most prominent symptoms include pain or throbbing in the middle of the penis or in any other area.

**Blood clot (thrombosis)**

A blood clot is most common in the dorsal vein of the penis, also known as Mondor's disease of the penis. The clot occurs as a result of red blood cells accumulating in the veins, which obstructs normal blood flow. Symptoms of a blood clot in the penis include:

Scrotal pain can decrease when lying down and resting.

**Epididymitis**: It is a small organ located between the testicles and the penis, and is responsible for storing sperm. The pain is usually concentrated in the upper part of the scrotum, and may sometimes be accompanied by swelling and redness. Epididymitis is most often caused by a sexually transmitted infection in men under the age of 35, while it is usually a bacterial infection in men over this age.

**Scrotum**: A man may feel pain in the scrotum due to the expansion of the blood vessels inside the sac and the increase in temperature of the testicles. This can be caused by carrying heavy weights, moving furniture for long periods, or standing for long periods. The pain often eases when lying down and resting, due to a defect in the veins that leads to blood pooling and feeling the pain of blood congestion, which may negatively affect the man's ability to produce sperm and testosterone.

**Testicular torsion**: A testicle can twist, cutting off the blood flow that supplies it with oxygen, causing severe pain in the testicles. In some cases, the pain may be accompanied by nausea and vomiting. If the pain is ignored and left untreated, it may lead to the loss of the testicle.

**Sexually transmitted diseases**: People may experience pain in the penis due to a sexually transmitted infection (STI). Common symptoms of these conditions include: pain during ejaculation, yellow, white, or clear discharge, lumps around the genitals, pain or burning sensation when urinating, pain during sex, and rash or itching.

**Phimosis (light 

**Phimosis**: This is a condition that occurs when the foreskin becomes too tight to be pulled back over the head of the penis. This condition is common in young children before the foreskin becomes loose, but it can also cause painful symptoms in teens and adults.

**Paraphimosis**: This is a condition in which a person is unable to pull the foreskin forward over the tip of the penis. It is a serious condition that requires immediate medical attention. Additional symptoms include: pain in the penis, swelling at the tip of the penis, and a blue or red discoloration of the head of the penis.

**Treatment options for penile pain**: Treatment varies depending on the condition or disease:
- Injections may be used to reduce scarring from Peyronie's disease, and in severe cases, surgery may be required.
- Draining and removing blood from the penis with needles can reduce erections in cases of priapism, and medications may reduce the amount of blood flowing to the penis.

- Antibiotics may be used to treat urinary tract infections and some sexually transmitted diseases, such as chlamydia, gonorrhea, and syphilis. Antibiotics and antifungal medications can also treat balanitis. Antiviral medications can help reduce or shorten the duration of herpes outbreaks.

Stretching the foreskin with your fingers can increase its flexibility in cases of phimosis, and using steroid creams on the penis may also be helpful. In some cases, surgery may be necessary.

Applying ice to the head of the penis can help reduce swelling, and your doctor may also recommend applying pressure to the head of the penis. Certain medications can be injected into the penis to help drain blood, or small cuts can be made in the foreskin to reduce swelling.

Cancerous tissue can be surgically removed from the penis, and cancer treatment may also include radiation or chemotherapy.

For penile pain, Peyronie's disease sometimes goes away without treatment. However, some people with it may need:

- Taking oral medications.
- Injecting medication into the plaque.
- Ultrasound or radiation therapy to break up scar tissue and reduce plaque.
- Shock wave therapy, which uses electrical shock waves to break up scar tissue.

If symptoms are severe and don't improve, a person may need surgery.

For balanitis, over-the-counter pain relievers such as ibuprofen (Advil) or aspirin (Bayer) can help reduce the inflammation and redness caused by sunburn and ease the pain associated with it. If balanitis is left untreated, it can lead to phimosis, where the foreskin becomes too tight to be pulled back from the head of the penis.

Treatment options for balanitis include:

- Using a topical antibiotic, antifungal cream or antiseptic.
- Applying topical steroids.
- Using a topical astringent solution.
- Enhancing virility.

Medical treatment may include:

- Pain medications, such as opioids.
- Injections of medication into the penis to improve normal blood flow.
- Making a small hole or passage, known as a shunt, to facilitate blood flow between the penis and the rest of the body.

For sexually transmitted infections (STIs), treatment may include:

- Antibiotics to treat bacterial infections such as chlamydia, gonorrhea, and syphilis.
- Medications to treat symptoms associated with viral infections such as herpes.

For urinary tract infections (UTIs), your doctor will usually prescribe antibiotics such as ciprofloxacin (Cipro) and levofloxacin to treat the condition.

For prostatitis, antibiotics can be used to treat it, in addition to pain relievers, prostate massage, and warm compresses to relieve symptoms.

Your doctor will usually prescribe antibiotics to treat urethritis, including:

- Adoxa, doxycycline (Vibramycin), Monodox, Oracea.
- Azithromycin (Zmax), Zithromax.
- Ceftriaxone (Rocephin).
- Metronidazole (Flagyl).
- Tinidazole (Tindamax).
- Acyclovir (Zovirax).
- Famciclovir (Famvir).
- Valacyclovir (Valtrex).

Treatment for phimosis usually involves applying a steroid cream daily to the foreskin, and painkillers can also help.

Treatment for paraphimosis focuses on reducing swelling at the end of the penis to allow the foreskin to return to its normal position.

If the penis is fractured, a person will need urgent medical care, and surgery may be required to drain the accumulated blood and repair any damage.

Treatment for penile cancer may include:

- Surgery to remove tumors from the penis.
- Circumcision to remove the foreskin.
- Radiation therapy to destroy cancer cells.
- Chemotherapy.