| Male dyspareunias
Dyspareunias, or pain during sexual intercourse, most frequently
affect women but rarely her partner. Nevertheless, male dyspareunias
also exist, although less frequent.
Often underestimated, the pain felt in male dyspareunia consists
of pain of the penis during sex, excluding ejaculation. This pain,
although mostly benign, turns out to be quite worrying for men.
Psychological and psychosomatic male dyspareunias can be compared
to feminine psychogenic dyspareunias. It is important to eliminate
organic factors, in order to avoid missing carcinogenic pathologies.
- Acquired curvatures of penis or fibrous cavernitis
In this case, a plate of fibrosis of the enveloppe of corpora
cavernosa (which can progressively thicken and calcify curving
more or less the erect penis) makes penetration difficult and
sometimes even impossible.
This deformation, moderate at first, can evolve little by little,
within several years, towards a more important deformation. Pain
can occur during erection, along with erection difficulties.
The fibrous cavernitis is a benign affection that evolves on approximately
a four-five years period. In 25 % of the cases, the plate declines
spontaneously without treatment. Others will require a surgical
treatment if the deformation is too important affecting penetration
or in case of severe dyserection.
-Dyspareunias repair post-surgery of fibrous cavernitis
-Penile fracture must not be confused with the fibrous cavernitis
Penile fracture sometimes occurs during coitus, in case of a too
rough or too fast position change on an erect penis. This rough
deformation of the penis comes along with very intense pain.
-Phimosis or stenosis of the preputial ring
During the erection, the prepuce cannot be retracted behind the
penis glans, causing dyspareunias. Phimosis can be the result
of a narrow prepuce, damages due to forced retractions, infections,
tumors of the penis, diabetes...
Sometimes, phimosis is reduced by manual retraction of the prepuce,
with a possible lubrication or disinfection. For more important
phimosis, a simple intervention enlarging the prepuce is sufficient.
In even more severe cases, circumcision remains the best option.
Phimosis can cause a specific complication: the paraphimosis.
-Paraphimosis
Paraphimosis is a physiological and medical situation : prepuce
stays blocked on the penis, behind the glans. The paraphimosis
is a medical emergency, but a rather effective and simple procedure
can be tried beforehand: pouring some cool water (not frozen)
on the penis reducing its volume, then compressing the edematized
glans between the thumb and the fingers in order to replace the
prepuce back on glans. A medical lubricant will facilitate the
procedure.
-Penis brake rupture
This rupture arises suddenly on very short penis brake during
sexual intercourse. Intense pain and important but benign bleeding
then occur. Penis brake can heal and rupture several times. The
residual cicatrices sometimes ache and chronicisent the dyspareunia
after the traumatic episode. A plastic surgery of penis brake
elongation under local anesthetic resolves the problem.
-Dermatological and infectious penis affections as scléro-atrophic
Lichens, lichen plan(shot), irritating dermatitis (due to the
lack of hygiene), caustic dermatitis (by excess of hygiene) and
chronic balanites (glans inflammation under the prepuce owed to
a deficient or excessive hygiene) can cause dyspareunias especially
by means of a phimosis or of a paraphimosis.
Some dyspareunias are related to a hyper-responsiveness of the
glans associated to other sexual difficulties or to psychogenic
factors.
What about pains during ejaculation?
They are often of infectious origins (IST, urinary tract infection,
urethritis, epididymitis, prostatitis) or related with a stenosis
or an urethral stenosis (post-surgical, post-infectious, congenital,
benignant prostate hypertrophy. They are often associated with
mictional disorders (urinary burns, mictional embarrassment).In
conclusion dyspareunias can seriously disturb sexuality and relationships,
it is thus important to consult and to speak about it because
a medical or surgical treatment can be effective.
|