AboutArthur Goldstein, M.D. Expertise Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.
Experience I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.
Organizations American Medical Association, American Urological Association, American College of Surgeons
I have recently noticed a small lump on my penis. It's roughly halfway along the top of the shaft. In addition there seems to be a hardened vein which can be felt just under the skin. It runs along the top of the shaft down to the base. The hardened lump appeared spontaneously and remains the same size but the vein seems to be getting harder/ longer.
Neither problem is very painful at the moment but are uncomfortable to touch. Both lump and vein are more noticeable (and painful) when I have an erection. But even while limp the hardened vein can be felt beneath the surface.I currently have no problem getting an erection. However when I have an erection I have noticed that all of the veins on my penis are now more prominent.
I had unprotected sex on one occasion (when the condom split). Sometime afterwards I experienced a mild burning sensation around the opening of my penis. However I did not experience any discomfort while urinating and this problem ceased around a month later. I do not know if this is related.
I am a 25 year old from Ireland. I am not sexually active on a regular basis, other than masturbation. I am circumcised and had surgery to treat a varicose seal when I was 19. I am not taking any prescribed medication. I have not yet discussed this problem with a doctor. I am naturally concerned about this problem. Any advise would be very much appreciated. Thanks for your time- S
Answer Shane, your symptoms may be caused by a clot (thrombosis) in penile lymphatics (tissue vessels). This is usually caused by sexual trauma (even mild trauma may be the culprit) but this generally clears up spontaneously in 1-2 weeks. However, my guess is that your time table is longer than this. Therefore, the most likely etiology of your problem is Peyronie's disease. 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. With erection, the nodules act like a bowstring and prevent that portion of the corpora from expanding. The result is curvature or deviation of the penis. Many therapies have been tried including medications (POTABA, vitamin E, etc.), ultrasound, radiation, steroid injections, etc. but none works universally well. Most often vitamin E 400 i.u. daily is used. It can't hurt and might help. 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 sensory nerves which often are wrapped up in the scar. If a man is impotent, often the best solution is to place a penile prosthesis which corrects the deformity and solves 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. Good luck!
