What is sclerosing lymphangitis of the penis?

Sclerosing lymphangitis of the penis refers to a condition where the superficial lymphatic vessels in the coronal sulcus or dorsal part of the penis become thickened and hardened due to mechanical stimulation, leading to lymphatic obstruction and the appearance of tortuous, cord-like swellings.

What causes sclerosing lymphangitis of the penis?

The exact cause of sclerosing lymphangitis of the penis remains unclear.

Epidemiological studies suggest that it is primarily associated with frequent or vigorous sexual activity, which damages the lymphatic vessels under the penile foreskin, causing localized lymphatic reflux obstruction. This leads to lymphatic vessel dilation, subsequent aseptic inflammation, thickening and hardening of the lymphatic vessel walls, and the formation of lymphatic thrombi.

Common contributing factors include rough intercourse, frequent intercourse within a short period, prolonged intercourse, excessive masturbation, as well as tuberculosis, viral infections, and other factors.

Who is most commonly affected by sclerosing lymphangitis of the penis?

This condition is most common in sexually active young and middle-aged men, particularly those who engage in excessive masturbation, overuse of erectile dysfunction medications, or have unhealthy sexual habits.

What are the main symptoms of sclerosing lymphangitis of the penis?

It typically occurs within days or up to a week after rough sexual activity (including aggressive masturbation) or prolonged intercourse following the use of erectile dysfunction drugs. The main symptom is the appearance of curved, worm-like, firm cord-like structures in the coronal sulcus or dorsal part of the penis. These structures are movable under the skin, translucent, and usually painless, though mild pain may occur occasionally. In rare cases, ulcers may form.

How is sclerosing lymphangitis of the penis diagnosed?

The diagnosis is primarily based on medical history and the observation of cord-like, worm-like, or nodular, moderately firm masses on the penis. Further pathogen testing may be conducted as needed.

Pathological examination after surgical removal may reveal lymphatic fibrosis and thickening, but early biopsy is not recommended.

How is sclerosing lymphangitis of the penis treated?

The condition is self-limiting, and most patients do not require medication or surgical intervention. Symptoms often resolve on their own after abstaining from sexual activity for several weeks. For patients with localized pain, warm compresses or physical therapy may be applied. Surgical treatment may be considered if conservative measures fail (e.g., symptoms persist beyond 3 weeks).

What is the prognosis for sclerosing lymphangitis of the penis?

As a self-limiting condition, it usually resolves within weeks of abstinence and does not significantly impact daily life. Recurrence is rare if unhealthy sexual habits are corrected and the use of erectile dysfunction drugs is discontinued.

How can sclerosing lymphangitis of the penis be prevented?

Adopting a healthy attitude toward sex and avoiding excessive pursuit of prolonged or overly stimulating sexual activity are key to preventing this condition. Men with phimosis should undergo circumcision in a timely manner.

Which medical department should be consulted for sclerosing lymphangitis of the penis?

Departments for consultation: Urology, Andrology, Dermatology & Venereology.