Penile abnormalities and common inflammation prevention: From priapism to balanitis prevention and treatment

Penile erections can occur five or six times a day, a phenomenon that does not change with age and can still occur in men in their sixties and seventies. However, if an erection lasts for several hours or even tens of hours (commonly known as "uninterrupted erection"), it should be noted that it may be due to certain diseases. Any abnormal erection that lasts too long, is unaffected by sexual desire or is only minimally affected, and mostly occurs after intercourse, can be diagnosed as priapism.

Priapism is classified into primary and secondary types. Secondary priapism is more commonly seen in various diseases that cause pelvic vein thrombosis, such as metastasis of malignant tumors, leukemia, sickle cell anemia, thrombophlebitis, spinal cord injury, and local penile injury. Certain medications, such as thiazides, hepatoprotective agents, testosterone, and hydralazine, can also cause priapism.

In addition, some patients with hypertension, heart disease, or emphysema experience frequent penile erections when their condition worsens. This indicates that spontaneous and sustained penile erections are a response of the body to hypoxia. Men experiencing this problem can manage it through diet: ① Black Bean and Licorice Drink: 15 grams of black beans and 6 grams of licorice root, decocted in water and drunk frequently. ② Peach Kernel and Cuttlefish Soup: 10 grams of peach kernels and 1 cuttlefish. Clean the cuttlefish, cut it into pieces, and simmer it with the bones in the soup.

③ Motherwort and Black Bean Sweet Soup: Boil 30 grams of motherwort and 60 grams of black beans in 3 bowls of water until reduced to 1 bowl. Add an appropriate amount of brown sugar and consume. In various urological emergencies, one of the most embarrassing situations for patients is penile fracture. When the penis is not erect, it is a soft organ and cannot be broken. However, considering that the penis can become erect, penile fracture is a possibility.

The key to the penis's erectile function lies in the pair of corpora cavernosa within the penis. When the penis is erect, a large amount of blood flows into these corpora cavernosa. If, under these conditions, external force causes the corpora cavernosa to rupture, penile fracture will occur. When the penis fractures, in addition to experiencing sudden, severe pain, the person will also hear a crisp cracking sound.

The penis will then develop some swelling, which can quickly progress to severe swelling and bruising. At this point, the most appropriate course of action is to seek immediate medical attention and have the ruptured corpora cavernosa surgically repaired. This will immediately reduce the swelling and prevent future sexual dysfunction. Additionally, some patients with penile fractures may also experience urethral injury, resulting in bleeding from the urethral opening; this also needs to be addressed during treatment.

These types of incidents often occur when trying unusual sexual positions, causing penile twisting or sudden impact that leads to fracture. Some statistics suggest that the woman-on-top position during intercourse increases the risk of penile fracture. During consultation, doctors typically begin with initial differential diagnosis based on symptoms such as localized pain, redness, swelling, and urethral bleeding, followed by ultrasound or corpus cavernosum imaging.

For simple penile rupture without urethral laceration, a circumferential incision can be made in the foreskin to locate and suture the laceration. This treatment will not impair sexual function. However, if a urethral laceration is present, urethral repair surgery is necessary, ideally including a suprapubic cystostomy to prevent urine from entering the urethra and causing a fistula. The foreskin covers the glans penis and provides protection.

If there is a problem with the foreskin itself, it can also affect the glans, the most common being balanitis. The causes of inflammation can vary with age. For example, balanitis in infants and young children is often caused by diapers that are not breathable or by fecal contamination. Under the combined action of bacteria, urine, and smegma, redness, swelling, heat, and pain occur.

In adults, balanitis is partly related to phimosis, but unclean sexual intercourse, contact with certain chemicals, and trauma are also significant contributing factors. Balanitis can be broadly classified into four categories: traumatic, contact-related, drug-induced, and infectious. Traumatic balanitis is mostly caused by injuries such as being punched, caught in a zipper, or injured during intercourse. Drug-induced balanitis often presents with itching and burning sensations.

The most important diagnostic criterion is the use of a certain medication, with tetracycline being the most common cause of this inflammation. Syphilis can also cause balanitis, but it usually appears as a white, fused surface on the glans penis after a chancre has formed, accompanied by swelling. Prevention and care principles include wearing loose-fitting pants and maintaining local cleanliness and hygiene.

Recurrent balanitis should prompt consideration of circumcision. Adults should avoid unprotected sex and inappropriate sexual behavior. Those with allergies, especially when taking tetracycline or certain sulfonamide drugs, should inform their doctor beforehand, as these may trigger allergic balanitis.