and Testicular Health
Prostate, penis, and testicular health, the health of your reproductive organs, is an essential part of men’s health and includes much more than your ability to keep an erection, ejaculate, and reproduce sperm. Penis problems can be signs of underlying health conditions.
Problems related to sexual function and penis health include:
- Erectile dysfunction, the inability to get and keep an erection firm enough for sex
- Ejaculation problems, including the inability to ejaculate, premature ejaculation, delayed ejaculation, painful ejaculation, reduced ejaculation, or retrograde ejaculation (semen enters the bladder instead of emerging through the penis)
- Yeast infection, causing inflammation of the head of the penis (balanitis), a reddish rash, white patches on the penis, itching or burning, or a white discharge
- Peyronie’s disease, a chronic condition involving the development of abnormal scar tissue inside the penis, which can result in bent or painful erections
- Penile fracture, a rupture during an erection of the fibrous, tubelike tissue in the penis, typically caused by an erect penis striking the female pelvis too forcefully
- Priapism, a persistent and often painful erection that is not caused by sexual stimulation or arousal
- Phimosis, a condition in which the foreskin of an uncircumcised penis cannot be retracted from the penis head, resulting in painful urination and erections
- Paraphimosis, a condition in which the foreskin cannot be returned to its normal position after being retracted, causing painful swelling and impaired blood flow
- Penile cancer, which may begin as a blister on the foreskin, head, or shaft of the penis and then become a wart-like growth that discharges watery pus
- Sexually transmitted infections, including genital warts, gonorrhea, chlamydia, syphilis, and genital herpes that can cause painful urination, penis discharge, sores or blisters on the penis or in the genital area
- Anorgasmia, the inability to achieve an orgasm despite adequate stimulation
Consult your provider if you have any of the following signs or symptoms of penis health problems, including:
- Changes in the way you ejaculate
- Bleeding during ejaculation or urination
- Warts, bumps, lesions, rash on your penis or genital area
- Severely bent penis or curvature that causes any pain or interference with sex
- Burning sensation during urination
- Any severe pain or trauma to your penis
- Abrupt changes in sexual desire
Many men have erectile dysfunction, and there are many medical solutions. Our providers are here to work with you and help you decide on a treatment that is right for you.
Discussing the best treatment is also about uncovering the condition(s) that may be causing or worsening your erectile dysfunction, such as:
- Heart disease
- Substance abuse, including alcohol and tobacco
- Psychological issues
Once underlying causes are understood, your provider can discuss the best treatment options for you. Erectile dysfunction is often treated with oral medications, but they are not effective for everyone and may even be harmful if you:
- Have very low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)
- Take drugs prescribed for chest pain
- Have severe liver disease
- Receive dialysis for kidney disease
Some men may opt for non-oral treatment options to avoid possible side effects from particular oral medications.
Non-oral treatments include:
- Self-injections. Some medications are injected directly into the penis to achieve an erection. A very fine needle is used to inject the medications into the base or side of your penis, producing an erection that typically lasts about 20 to 40 minutes. If it lasts longer than an hour, your provider will work with you to make adjustments. Side effects may include bleeding from the injection, a prolonged erection (priapism), and possible formation of fibrous tissue within the penis or at the injection site.
- Alprostadil urethral suppository. Alprostadil intraurethral (Muse) therapy places a tiny alprostadil suppository in the penile urethra using a special applicator. An erection typically starts within 10 minutes and lasts between 30 and 60 minutes. Side effects may include some pain, minor bleeding in the urethra, and formation of fibrous tissue inside your penis.
- Testosterone replacement. Some men’s erectile dysfunction is complicated by low levels of the hormone testosterone. Testosterone replacement therapy (TRH) might be recommended as a first step. There are various methods it can be delivered. Your provider will discuss all options and possible side effects.
Penis Pumps, Surgery, and Implants
Penis pumps, surgery, and implants are additional non-oral options for consideration:
- Penis pumps. A penis pump is a hollow tube with a hand-powered or battery-powered pump. It is placed over your penis, and the pump sucks out the air inside the tube, creating a vacuum that pulls blood into your penis.
Once an erection occurs, you slip a tension ring around the base of your penis to hold in the blood and keep it firm, removing it after intercourse. A possible side effect of this method is bruising of the penis, ejaculation restriction caused by the band, and the penis feeling cold to the touch.
- Penile implants. This treatment entails surgically placing implants, either inflatable or semi-rigid rods, into both sides of the penis. These devices allow you to control how long you have an erection. The semi-rigid rods keep your penis firm but bendable. Note that penile implants are usually not recommended until other methods have been tried first. Still, they have a high degree of satisfaction among men who have not had success with other therapies. As with all surgery, there are risks, such as infection.
- Blood vessel surgery. Rarely, erectile dysfunction is treated by bypassing obstructed penile arteries.
Psychological Counseling is Sometimes Helpful for Erectile Dysfunction
Your provider may recommend that you, or you and your partner, see a therapist If your erectile dysfunction is caused by anxiety, stress, or depression, or your condition is creating relationship stress or tension. They may refer you to our therapists in our Hickory clinic.
Do not feel embarrassed about talking with your health care provider about any concerns. Our providers are professional, caring, and here to help.
Your prostate is a walnut-sized gland located between your bladder and penis. Your urethra runs through the center of the prostate, from the bladder to the penis, where urine exits your body. During ejaculation, the prostate secretes fluid into the urethra that nourishes and protects sperm.
Conditions that affect the prostate include:
- Prostatitis is inflammation of the prostate, often caused by infection and typically treated with antibiotics, other medications, and/or surgery.
- Enlarged prostate (benign prostatic hypertrophy or BPH) affects all men over 50 and can impede normal urine flow. Typically medicines resolve symptoms of an enlarged prostate, but sometimes surgery is necessary to address symptoms and avoid further complications from BPH.
- Prostate cancer is the most common form of cancer in men (besides skin cancer). Surgery, radiation, hormone therapies, cryotherapy, or chemotherapy are all options for treating this cancer. Some men choose to delay treatment, as prostate cancer is typically very slow-growing and often not the cause of death in older men. This option is called watchful waiting and requires regularly scheduled follow-up testing.
Prostate Tests include:
- Digital rectal examination (DRE) involves feeling the prostate with a gloved finger in the rectum to detect an enlarged prostate, lumps, or nodules
- Prostate-specific antigen (PSA) involves a blood test to measure a protein made by the prostate. If PSA is high, prostate cancer is more likely, but not definitive, as an enlarged prostate can also cause an elevated PSA. Screening recommendations based on age differ among medical experts. Talk with your provider as to whether screening makes sense for you.
- Prostate ultrasound (transrectal ultrasound) involves inserting a probe in the rectum to bring it close to the prostate for imaging. Ultrasound is often done with a biopsy to test for prostate cancer.
- A prostate biopsy involves inserting a needle into the prostate to take tissue samples for testing.
Testicular Health and Testicular Cancer
Testicles (testes) are located inside the scrotum, a loose bag of skin beneath the penis. Testicles produce male sex hormones and sperm for reproduction.
Testicular cancer is rare, but it is the most common cancer in American males between the ages of 15 and 35. It usually appears in just one testicle. The good news is that it is highly treatable, even when it has spread beyond the testicle. Depending on the type and stage of this cancer, you may receive one of several different treatments or a combination of treatments.
Symptoms of testicular cancer include:
- Lump or enlargement in either testicle
- Pain or discomfort in a testicle or the scrotum
- Feeling of heaviness in your scrotum
- Sudden collection of fluid in the scrotum
- Dull ache in the abdomen or groin
- Enlargement or tenderness of your breasts
- Back pain
See your provider if you detect any of the above symptoms, especially if they last longer than two weeks.
Catawba Valley Primary Healthcare is here for all your primary healthcare needs. Call us at (828) 695-5900.