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Urology/Unknown Penile disease


Good day.

I am 26 years old and I suffer for over half a year now from penile symptoms which make me increasingly depressed and hopeless.
Usually, I am a happy person and was before this incident.
Everything was going fine and smoothly with job and private life and I was very satisfied.
So a purely psychological reason can be excluded.


The first symptom in March 2013 was an acute, pulsating pain under the glans of the penis on the right side.
I went to a urologist (emergency room) immediately, who did an ultrasound and was unable to tell me what I was suffering from.
He prescribed pain meds and sent me home.
The next weeks and months this pain would not go away completely.
Erections changed in shape (thinner) and became increasingly painful.

In June I noticed one morning that my penis was shrunken to an unnatural degree while lying in bed.
Over the course of the next weeks my penis would routinely contract while flaccid and become extremely small and hardened to the touch.
The testicles were not affected by this and in a completely relaxed state.
This hardening of the entire penis (except the glans) is very painful, I experience it to this day.
It happens all the time, and only relaxes sometimes while sitting down.

The penis has become a lot smaller and thinner. Erections are hard to achieve, to maintain and are then painful.
This pain is cramp-like all over the penis except the glans.

The size when erect has decreased consistently by an inch.

There is no curvature upon erection.


I cannot remember an injury preceding these problems, but I did have local infections (on the right sight below the glans, close to the location of the later pain).
These were skin infections with redness, pus-filled wound.
This resulted from a benign epidermal cyst I unfortunately scratched open while in the bath back in December 2012.
It has now healed but was quite red for a long time.
There is a left over redness which looks a lot like this:


I was in a urological clinic and several tests have been done:
MRT of the pelvic area (but the penis itself could not be evaluated), blood tests (including hormones, markers for infection etc.), urethral swaps, ultrasound and palpation of penis and testicles (countless times).

These tests came back negative.
But the urologist did note that indeed the penis was unusually hardened and the skin would bulge up indicating a significant contraction.
No explanation could be provided.
Peyronie's was definitely ruled out by the andrologist.


I have been prescribed PDE-5 inhibitors for my erectile difficulties.
I tried Vardenafil in a low dose. It gave me an erection which was painful and I had many side-effects so I stopped taking them.


Which tests should be done next?

Could this be caused by my earlier skin infections?

What are general reasons for a shrinking of the penis?
How can this happen at my young age?

I hope the text is not too long, I tried to contract it as much as possible.

Many many thanks for any information,


First, there is no clear diagnosis so it's impossible to classify your problem from the available information.

I also cannot indicate what tests should be done next because it appears likely that no clear diagnosis may be possible.  Peyronie's disease seems like the best fit but this is ruled out if you believe the andrologist.  

Since we don't have a definitive diagnosis, it's also not possible to determine if your earlier skin problems have anything to do with it.  A rheumatology consult might help shed some light on this aspect.

My best suggestion is to seek an opinion from a tertiary care center like Mayo clinic that is used to seeing complex or difficult cases.


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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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