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Male sexual and penile conditions

64 articles

Increased libido

Increased libido (ICD-11 MB22.6) is a symptom: sexual desire or activity above the patient's own baseline. Distinct from hypersexuality/CSBD; caused by dopaminergic drugs, mania, brain lesions, SSRIs.

Low-flow priapism

Low-flow (ischemic) priapism is a painful erection over four hours from trapped, deoxygenated blood in the corpora cavernosa; over 95% of priapism cases, treated by aspiration plus phenylephrine, then shunts or penile prosthesis.

Melanoma of penis

Melanoma of penis (penile melanoma, ICD-11 2C81.1): rare melanoma of the penis, about 1.4% of penile cancers and under 0.1% of melanomas, usually on the glans, treated surgically with poor but improving survival.

Micropenis

Micropenis: a structurally normal penis with stretched penile length over 2.5 SD below the age-matched mean; under 2 cm at birth, under 4 cm after age 5. Causes include hypogonadism; treated with early testosterone or DHT.

Nocturnal emission

Nocturnal emission (wet dream, nightfall): involuntary ejaculation during sleep, a normal part of male puberty, typically first occurring at 13-14 years with 70-90% prevalence; occurs with or without erotic dreams and has clinical uses in anejaculation.

Nocturnal penile tumescence

Nocturnal penile tumescence (sleep-related erection): spontaneous REM-sleep erections in healthy males, measured clinically with the RigiScan NPTR test to distinguish psychogenic from organic erectile dysfunction, mainly in selected and medico-legal cases.

Pain in penis

Pain in penis (ICD-11 MF40.00), any penile pain or discomfort; causes include priapism, Peyronie's disease, urethritis, balanitis, trauma, penile fracture, and referred or neuropathic pain; priapism and fracture are emergencies.

Paraphimosis

Paraphimosis: urologic emergency in which the retracted foreskin is trapped behind the glans corona, causing edema and ischemia; distinct from phimosis; treated by manual reduction, osmotic agents, or dorsal slit.

PDE5 inhibitor

PDE5 inhibitors (sildenafil/Viagra, tadalafil/Cialis, vardenafil, avanafil) block phosphodiesterase type 5, prolonging NO-cGMP signalling. Developed for angina, approved for erectile dysfunction from 1998 and pulmonary arterial hypertension; nitrates are contraindicated.

Pearly penile papules

Pearly penile papules (PPP), also called hirsutoid papillomas or papillomatosis corona penis, are benign 1-2 mm pink, white, or yellow bumps in rows around the corona of the glans penis; not an STI, common in uncircumcised men, needing no treatment.

Penile cancer

Penile cancer: rare squamous cell carcinoma of the penis, about 1% of male cancers; HPV is the main risk factor; 67% five-year relative survival; treated with penile-sparing surgery, radiotherapy, or amputation.

Penile fracture

Penile fracture: rupture of the tunica albuginea of the erect penis, usually during intercourse, masturbation, or taqaandan; presents with a cracking sound, detumescence, and hematoma, and is treated by urgent surgical tunica repair.

Penile implant

Penile implant (penile prosthesis): surgically implanted device treating drug-refractory erectile dysfunction. Inflatable (most common, three-piece since 1973) and semirigid types; 45-90 minute surgery, high satisfaction, infection is the main risk.

Penile subincision

Penile subincision, or burra, is a urethrotomy splitting the ventral penis and urethra, practiced as a coming-of-age ritual in Western and Central Australian indigenous communities, with sacred blood-letting and debated origins.

Penis captivus

Penis captivus (captive penis, coitus ligatus) is a rare, disputed phenomenon of temporary penile entrapment in the vagina from involuntary pelvic floor spasm, documented mainly through historical BMJ accounts from 1884 to 1980.

Persistent genital arousal disorder

Persistent genital arousal disorder (PGAD), also called genito-pelvic dysesthesia, is a distressing condition of unwanted genital arousal without sexual desire, first described in 2001, with prevalence estimates of 0.6–3% and neuropathic, pelvic floor, and medication-related causes.

Peyronie's disease

Peyronie's disease: fibroproliferative plaque of the penile tunica albuginea causing curvature, pain, and erectile dysfunction in men 40-70; collagenase is the only FDA-approved drug.

Phimosis

Phimosis: inability to fully retract the foreskin over the glans. Normal in boys under 5-10; pathological forms cause scarring. Treated with topical steroids or surgery; paraphimosis is an emergency.

Post-selective serotonin reuptake inhibitor sexual dysfunction

Post-SSRI sexual dysfunction (PSSD), also called post-selective serotonin reuptake inhibitor sexual dysfunction, is persistent genital numbness, pleasureless orgasm, low libido, and erectile dysfunction continuing after stopping SSRIs or SNRIs; recognized by the EMA in 2019, estimated risk about 0.46%.

Post-vasectomy pain syndrome

Post-vasectomy pain syndrome (PVPS), also called chronic orchialgia or postvasectomy orchalgia, is chronic scrotal pain lasting over three months after vasectomy, affecting roughly 1-5% of men, treated with medications, nerve blocks, denervation, or reversal.

Postorgasmic illness syndrome

Postorgasmic illness syndrome (POIS), also called post-orgasmic illness syndrome, is a rare urogenital syndrome of flu-like, allergic-type, and cognitive symptoms within hours after ejaculation, lasting 2 to 7 days; first described 2002, fewer than 100 reported cases, cause unknown.

Premature ejaculation

Premature ejaculation (PE), also called early ejaculation, is a common male sexual dysfunction defined by ejaculation within about one minute of penetration (lifelong) or a bothersome drop to about three minutes (acquired), treated with dapoxetine, topical anaesthetics, or SSRIs.

Priapism

Priapism is a persistent penile erection unrelated to sexual stimulation, lasting over four hours. Subtypes are ischemic (over 95% of cases, an emergency), non-ischemic, and stuttering; treated by aspiration plus phenylephrine, shunts, or embolization.

Prostaglandin E1

Prostaglandin E1 (PGE1, alprostadil; Caverject, MUSE) is a naturally occurring vasodilator lipid and synthetic drug that raises cAMP in smooth muscle; used mainly as second-line injectable, intraurethral, or topical therapy for erectile dysfunction.

Prostate massage

Prostate massage (prostatic massage) is pressure on the prostate via the rectum; historically a prostatitis treatment abandoned by urology, now mainly diagnostic (Meares-Stamey test) and for sperm retrieval in anejaculation; contraindicated in acute bacterial prostatitis.

Redundant prepuce

Redundant prepuce (ICD-11 GB05.0, 過長包皮) is excess foreskin fully covering the non-erect glans penis; benign cases need hygiene only, while symptomatic cases may need circumcision or revision.

Retrograde ejaculation

Retrograde ejaculation (dry climax): semen travels backward into the bladder during orgasm because the bladder neck fails to close. Causes include diabetes, TURP, RPLND, and alpha-blockers; treated with pseudoephedrine, imipramine, or sperm retrieval from urine.

Sclerosing lymphangitis of penis

Sclerosing lymphangitis of the penis, also called non-venereal sclerosing lymphangitis or benign transient lymphangiectasis, is a rare benign cord-like swelling at the coronal sulcus after vigorous sex, self-limiting within weeks.

Sexual anhedonia

Sexual anhedonia is reduced or absent pleasure from sexual activity; the orgasm-limited form, orgasmic anhedonia or pleasure-dissociative orgasmic dysfunction (PDOD), is ejaculation or orgasm without pleasure, distinct from anorgasmia, with limited treatment data.

Sexual dysfunction

Sexual dysfunction, also called sexual disorder, is the inability to participate in sexual relationships as wished, affecting about 31% of men and 41% of women; it spans desire, arousal, orgasm, pain, and ejaculation problems, treated with psychotherapy, PDE5 inhibitors, flibanserin, and testosterone.