Palpate the shaft from the glans to the base of the penis. The presence of scars, ulcers, nodules, induration, and signs of inflammation must be noted. To palpate the corpora cavernosa, hold the penis between the fingers of both your hands and use your index fingers to note any induration. Figure 18-22 illustrates the method of palpation of the shaft of the penis.
The presence of nontender induration or fibrotic areas under the skin of the shaft is suggestive of Peyronie's disease. Patients with this condition may also complain of penile deviation during erection. The erect penis has a deviation in the long axis, making sexual intercourse difficult or impossible. The patient or his partner may also complain of pain during intercourse. The site of predilection is the dorsal aspect of the penis, especially in the middle or proximal third. Figure 18-23 shows the penis of a patient with Peyronie's disease.
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