Malformations of the penis include epispadias and hypospadias. Both may be associ-ated with undescended testes. Epispadias is a urethral opening on the dorsal surface of the penis, while hypospadias is a urethral opening on the ventral surface. Both have an increased risk of urinary tract infection and infertility.
Balanitis/balanoposthitis is inflammation of the glans penis, and the glans and foreskin, respectively. Causes include poor hygiene and lack of circumcision.
Peyronie disease is penile fibromatosis resulting in curvature of the penis during erection
Condyloma acuminatum is a warty, cauliflower-like growth, with the causative agents most frequently being HPV serotypes 6 and 11.
Squamous cell carcinoma (SCC) is uncommon in the United States, and is often related to infection with HPV serotypes 16 and 18. There is an increased risk in uncircumcised males (multicentric carcinoma in situ). Precursor lesions include Bowen disease, bowenoid papulosis, and erythroplasia of Queyrat (a red plaque with carcinoma in situ histology).
Priapism is a persistent painful erection that can be caused by sickle cell anemia (causes blood sludging in penis), trauma, and drugs (e.g., trazodone).
Erectile dysfunction (ED). Causes of impotence include psychological factors, decreased testosterone, vascular insufficiency (most common cause age >50), neuro logic disease (multiple sclerosis, diabetic neuropathy, radical prostatectomy), some medications (leuprolide, methyldopa, finasteride, psychotropic medications), hypo-thyroidism, prolactinoma, and penile disorders.
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