Urology/Lump in penis
I discovered a lump inside my penis shaft- its best to describe it as located on the corpus cavernosum. Sometimes i can find it with little effort, other times I have to search for it. I went to see an urologist but it was difficult to locate it so I'm not sure he felt it (was having difficulty finding lump). But he said he feels nothing to be concerned about. I have a fairly straight erection. It' s easier to find when not erect. This lump is internal. I have not known about it for long. It's located left chamber dorsal mid shaft. I have no pain. But where it is I've had sensitivity dull ache when brushed against. I just sleep with my wife, been tested. No topical concerns.
Is this lump cause for worry. What if the urologist missed it?
Adam, the lump is most likely early Peyronie's disease which is a perfectly benign condition. Cancers of the corpoa cavernosum are exceedingly rare. In fact, I cannot recall ever seeing or reading about such a case in my many years of practice. To follow is a "macro" I have written on Peyronie's disease which will give you further insight into the condition.
Peyronie’s disease was first described in the 1700’s. It is a common, benign disease of the penis of unknown cause characterized by the development of firm nodules (plaques) in the membrane surrounding the erectile bodies of the penis (corpora cavernosa). These nodules are masses of inelastic scar tissue. Although many men are asymptomatic, the nodules may act like a bowstring and prevent that portion of the corpora from expanding. The result is curvature or deviation of the penis with erection. In more severe cases, impotence may occur. In the majority of cases, however, discomfort in the lesions with erection disappears but the curvature persists. Many of these patients require no treatment. The severity of the curvature may also cause discomfort on the part of the patient's partner during sexual intercourse. By experimenting with various positions, several can usually be found that are tolerable.
The diagnosis is generally made by palpation. In questionable instances, medication can be injected into the penis to produce an erection followed by re-examination in the erect state. Specialized x-ray studies called corpus cavernosograms are sometimes utilized for further evaluation. Calcification is present in the plaque in 20-25% of cases. Penile Doppler ultrasound may or may not demonstrate the lesions.
Many therapies have been tried including medications (POTABA, vitamin E, etc.), ultrasound, radiation, steroid injections, but none works universally well. The most often used treatment is vitamin E 400 i.u. daily. Recently, however, the vitamin has received some unfavorable press regarding potential side effects and should not be taken without consulting your physician. Early in the disease, the injection of collagenases or the calcium channel blocker Verapamil into the plaque may cause improvement. Verapamil has also been used in a cream or gel formulation with some success. This is of no value if the plaque is calcified. Likewise oral Pentox has produced disappointing results. A clinical trial is presently being done at Baylor University Medical School that using intra-lesioinal injection of Botox. To date, he results are not dramatic.
Surgery is reserved for severe cases where either the deformity is extreme or the man is impotent and wishes this corrected. Fortunately, these cases are in the minority. Surgical excision of the plaques of scar can be done but a tissue graft must be placed at the resected site. Graft shrinkage may result in recurrence of the problem. Great care must also be exercised at surgery not to damage the sensory nerves often entrapped in the scar. If a man is impotent, often the best solution is to place a penile prosthesis to correct the deformity and solve the impotence problem. As both types of surgery have complication rates, this treatment should be reserved for the most severe cases. I suggest that you consult with a urologist to confirm the diagnosis and to decide if any type of therapy is indicated at this time. Fortunately, the majority of cases stabilize on their own and do not require treatment. Good luck.