Penile Tuberculosis

Penile TB accounts for 4% of genitourinary TB; lesions may occur on the penile skin, corpora cavernosa, or urethra. Bacilli may spread from urinary tract TB, via intercourse, or contact with contaminated clothing; hematogenous spread is debated. Onset begins as a slightly red tuberculous nodule on the glans, frenulum, or external urethral meatus; the center ulcerates and depresses, surrounding tissue hardens, and the base shows caseous necrosis. As the ulcer enlarges, inguinal lymph nodes swell.

Common Symptoms

Nodule; penile pain; penile and scrotal edema; superficial penile ulcer; penile induration

Causes and Pathogenesis

(1) Etiology: Penile TB mainly results from direct contact of the penis with M. tuberculosis, rarely hematogenous; severe urethral TB can also involve the penis. (2) Pathogenesis: Lewis (1946) reported 65% of primary penile TB resulted from oral suction to stop bleeding during religious circumcision (now abandoned). Contact between the glans and diseased cervix can also cause penile TB; hematogenous infection directly invokes the corpora cavernosa causing tuberculous cavernositis; another route is severe urethral TB progressing to periurethritis then invading the corpora and glans. Direct contact lesions occur on the glans, frenulum, or meatus, starting as tubercles then ulcers with clear margins, hard borders, and caseous/granulomatous bases; they may enlarge to involve the entire glans, with secondary inguinal node TB. Cavernosal TB shows nodular hyperplasia with fibrous deformity and occasional fistulas.

Treatment

Drug therapy, surgical treatment, supportive therapy

Preventive Measures

The fundamental measure is preventing pulmonary TB; advances in molecular biology may allow new prevention, diagnosis, and treatment methods to eliminate TB.

Department to Visit

It is recommended to visit the Urology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.