It hurts when a man gets hard

When a man has an erection, it is a little painful. As the main organ for sexual intercourse, if the penis is painful, it will definitely affect the quality of sexual life. Mainly, penis pain is a symptom of certain diseases. Excluding external injuries, the disease factor is what we need to pay attention to. It can be judged by possible disease characteristics. Let's take a detailed look at the situation of penis pain.

The center of male penis erection is mostly located in the limbic system of the brain. The limbic system is part of the olfactory brain surrounding the brain stem, including the olfactory area, amygdala, hippocampus and cingulate gyrus. These nerve nuclei are obviously interconnected with many areas of thalamus, hypothalamus and supracortical tissue. Stimulating the above areas can cause penis erection.

Diagnostic points

1. Medical history: The patient's medical history should be carefully studied, especially for patients with the first episode. The medical history can help to identify the cause of the abnormal erection. The patient should also be asked whether there have been previous episodes, their duration, and their treatment methods.

(II) Clinical manifestations: The disease usually occurs suddenly. In the absence of sexual desire, the penis will have a tonic and persistent erection, with severe swelling, itching or pain. The duration of the erection varies, from a few hours to a few weeks. If the erection lasts for more than 24 hours, the skin of the penis will be bluish-gray, the corpus cavernosum will be wooden-hard, and the pain will radiate to the thighs. A small number of patients complain of dysuria or urinary retention. There are also unstable manifestations such as emotional tension, irritability, suspicion, and timidity.

Examination showed that the corpus cavernosum of the penis was obviously swollen and tense, and the corpus cavernosum of the urethra and the glans penis were flaccid. The penis was hard and wood-like and had lost its elasticity.

1. Endocrine function examination: In addition to the usual testing of plasma testosterone and prolactin levels, ED patients also need to test LH, FSH, E2, etc. when necessary. Thyroid function, etc., needs to be evaluated for individual patients according to their condition.

2. Nocturnal penis erection and hardness test (NPT): Healthy men have 3 to 6 physiological erections during the rapid eye movement phase of sleep, each lasting 20 to 30 minutes. Even if there is a psychological cause, this erection will not be affected. Therefore, the NPT test has important reference value for distinguishing organic and psychological ED. It is necessary to perform NPT testing before sexual psychotherapy or before surgery.

3. Penile corpus cavernosum injection of vasoactive drugs to induce erection test (ICI): ICI is still a simple and easy examination method with certain diagnostic significance for diagnosing ED.

4. Color dual-function ultrasound multispectral examination: After the vasoactive drug prostaglandin E1 is injected into the penile cavernous body, the color dual-function ultrasound multispectral diagnostic instrument is used with a high-frequency probe to examine the penile cavernous body structure and arterial diameter, the maximum blood flow velocity during contraction and the blood flow velocity at the end of contraction of the penile artery, and the resistance index is calculated to evaluate the arterial perfusion and venous closure function of the deep cavernous body artery.

5. Radiographic examination and evaluation:

① Selective penile cavernous artery angiography: 90% of the CDDU examination results are consistent with selective angiography.

② Penile cavernosography: For patients with erectile dysfunction, if the CDDU examination results show EDV>5cm/s and RI<0.75, venous closure dysfunction can be considered, and further penile cavernosography is needed for a definitive diagnosis.

6. Neurological function evaluation: Clinical erection-related neurological function tests include the bulbocavernous reflex latency test (BCRLT), which reflects whether the neural pathways between the penis and the sacral erectile center (S2-S4) are unobstructed.

Pathological erectile dysfunction

(1) Blood diseases: such as sickle anemia, leukemia, erythrocytosis and thrombocytopenia. These diseases can cause blood sediment in the corpus cavernosum of the penis and lead to abnormal penile erection.

(2) Neurological diseases: commonly seen in spinal cord injury or inflammation and brain stem lesions, etc., and can also be seen in some patients after craniotomy where the central spinal cord is overexcited, leading to persistent abnormal penile erection.

(3) Mechanical lesions: such as external injuries to the genitals and advanced pelvic tumors. These lesions can continuously compress the base of the penis, affecting blood circulation and causing abnormal penile erection.

(4) Certain drugs: Drugs that can cause persistent abnormal penile erection include guanethidine, reserpine, compound antihypertensive capsules, etc. Hemostatic drugs such as 6-aminoacetic acid and diazepam may also cause it.

(5) Genital inflammation: If you suffer from prostatitis, it may cause thrombosis of the prostatic venous clusters, affecting the return of deep veins, resulting in abnormal erection of the penis, which is hard and not soft.