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Urology/Penis pain


I am a medical professional (don't want to say what i do) but have an extensive medical background. I have had penis pain just below the head, upper right side for around 2 years. It feels like a burning sensation. Definitely feels like it's topical but it may be internal.  Nobody can see a skin problem except for me - a slight possible irritation about the size of a nickel. To me it looks like the skin might have stretched too much - most dr's think I'm crazy. They say "that skin is supposed to stretch" In the beginning i was unable to walk without constant pain ( 8 out of 10). I have been to 3 urologists, 3 dermatologists, 1 therapist and my primary physician. All tests come back negative - including prostate exam and herpes. I even had a cystoscope, since i also have a history of kidney stones. I have taken Cipro for possible prostatitis, Diflucan for possible fungal infection, Valtrex for possible viral infection, applied lotrisone cream for possible fungal infection, applied antibiotic ointments, taken anti-inflammatories for pain, tried moisturizers, changing detergents ,changing soaps and using no soap at all. I am 50 yrs old, single and in good health - had to stop doing cardio workouts due to pain. I do a very small amount of exercise compared to what i once did.  One urologist referred me to a pain specialist - Dr. tried gabapentin first ( had horrible side effects), then lyrica , then effexor...To this day the pain (almost 2 years)  still exists but is milder or i have learned to deal with it better - not sure. I can masturbate, but usually have moderate pain during and following. I have had sex but it's painful during and after - even with sufficient lubricant. I suffer from chronic insomnia due to pain and worrying.  All my friends sense something is wrong - i'm not comfortable discussing this with them.  I have allowed this to totally change my life - was outgoing, enjoyed traveling and just enjoyed life. Now i am miserable and just want to get rid of this pain. I am currently taking just pain meds and low dose effexor. I am very sensitive to meds and don't want to take anything - especially since nothing seems to work. Any positive help would totally change my life. Thank You


You present a complex problem.  Cystoscopy would identify strictures and urethral lesions while the dermatologists are likely to spot a skin lesion no matter how minor.  You have had substantial evaluations with no positive findings.

Two additional thoughts occur to me.  One is to consider a skin biopsy.  If something is found, then at least there is a start at a diagnosis.  The other is a penile ultrasound and/or MRI.  If the skin is not the cause and neither is the  urethra, then it's reasonable to suspect something inside such as Peyronie's.  A soft tissue study might identify such pathology.

Finally, consider a consultation at a tertiary care university center like Mayo that often see complex or complicated cases like yours.  Good luck.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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