Lesions


Penile Lesions


Penile lesions are common. They interfere with sexual intercourse. The majority of surgical conditions of the penis relate to problems with the foreskin and glans and the need for circumcision. Carcinoma of the penis and Peyronie’s disease are rare.




History



Foreskin and glans



Phimosis


In most cases, phimosis is congenital. The foreskin has been tight since birth and the patient complains that it will not retract over the glans. In children, this may cause ballooning of the foreskin during micturition, with resulting balanoposthitis. In adults, the complaint is that it interferes with sexual intercourse.



Paraphimosis


This is a result of a patient having a phimosis. The foreskin is pulled back over the glans while washing and then is not returned. It may also occur during sexual intercourse. In hospital practice, it may occur while the patient is being catheterised and the foreskin is not returned to its correct place following this procedure. The foreskin forms a tight constriction around the glans, interfering with venous return and causing swelling of the glans and foreskin. The patient presents with considerable pain and a swollen glans penis.



Balanoposthitis


This is inflammation of the glans and foreskin. The patient complains of an attack of inflammation of the foreskin and glans. It may be associated with poor hygiene, but in children it is often associated with phimosis and collection of urine under the foreskin. In diabetics, it is often due to candida.



Balanitis xerotica obliterans


The patient will complain of thickening and tightening of the foreskin, and the inability to retract it.



Herpes genitalis


The patient will complain of painful vesicles on the foreskin or glans penis. There will usually be a history of sexual contact.


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May 18, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Lesions

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