The symptom of pain and itching in the penis can occur in various diseases, such as gonorrhea, ischuria, seminal emission, priapism, etc., all of which may be accompanied by this symptom. Some cases are primarily characterized by pain, referred to as penile pain, while others are accompanied by itching in the penis, known as penile pain and itching. If the pain occurs only during urination and feels like needle pricks, it is called painful urination, which will be discussed in a separate section.

Suwen.Jingmai chapter records "twisting pain in the genitals" and "sudden itching" in the penis. Zhubing Yuanhou Lun mentions "deficiency fatigue vaginal pain" and states that "cold causes only pain, while heat causes swelling." In the "urolithic stranguria" section, there is a discussion on the symptom of "pain in the penis." Since penile pain and itching can occur in various diseases, please refer to the relevant discussions for more information.

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1. Dampness-heat︰Pain and itching in the urethra accompanied by dark yellow urine, short and astringent urination with urgency and a burning sensation, or turbid urine, lumbago, or fever, thirst, yellow and greasy tongue coating, and wiry or rapid pulse. This is caused by dampness-heat accumulating in the lower energizer and descending into the bladder. Treatment should focus on clearing heat and draining dampness, using modified prescriptions such as Eight-Ingredient Rectification Powder or Han Tong Tang.
2. Fire-heat︰Short and reddish urine with a burning stabbing pain, or accompanied by fever, aphthae, dry mouth, a red tongue tip, and a rapid pulse. This is caused by heart channel fire-heat transferring downward to the small intestine. Heat in the heart affects the small intestine; when there is heat in the heart channel, it is often accompanied by symptoms such as aphthae, a red tongue tip, and a rapid pulse. The pain and itching symptoms are typically described as "pain in the urethra, with extreme pain leading to itching" ("Shen's Book of Life Preservation"). Treatment should focus on clearing heart fire and promoting urination, using modified prescriptions such as Redness-Removing Powder or Heart-Clearing Lotus Seed Decoction.
3. Static Blood︰The colicky pain in the urethra is severe, sometimes so intense it feels life-threatening, often accompanied by symptoms such as hematuria, lumbago, and spasmodic pain in the lower abdomen. The tongue may appear dark with ecchymosis, and the pulse is deep and hesitant, or there may be no significant changes in the tongue or pulse. Due to blood stasis obstructing the urethra, the pain is extremely severe and may be accompanied by hematuria. Treatment should focus on resolving the static blood, and the condition will naturally improve. "Using a single herb, Achyranthes Root soft extract, is remarkably effective" (Shen's Comprehensive Guide to Life Preservation), or modified prescriptions such as Carbonized Typha Powder, or the augmented Peach Kernel, Carthamus and Four-Ingredient Decoction can be employed.
4. Kidney Deficiency︰The pain and itching in the penis are not severe, sometimes mild and sometimes severe, with frequent urination or dribbling after urination, soreness or pain in the lower back, a pale tongue, and deep, thin, weak chi pulse. It is mostly caused by excessive sexual activity or withholding ejaculation during intercourse, which injures kidney qi. Therefore, it is always accompanied by symptoms of kidney qi deficiency such as soreness or pain in the lower back, dribbling after urination, and a deep pulse, with mild pain and itching in the penis. The treatment should focus on warming and tonifying kidney yang, using the Cistanche Pill with additions such as Dodder Seed and Achyranthes Root.

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1. 《Ancient and Modern Medical Records．External Genitalia Diseases》: "Excessive labor, improper diet, coupled with anger,... itching in the penis, occasional discharge of white fluid, sometimes severe pain, quickly relieved by tightly pinching with the hand. This is due to qi deficiency of the liver and spleen, treated with Rehmannia Pill and tonifying the middle and replenishing qi, plus Phelloendron Bark, Gardenia, Poria, and Akebia Stem, leading to recovery."
2. Zhangshi Yitong ．Seminal Emission》: "Seminal emission with itching in the penis and incontinence of the urinary tract is due to yang deficiency with fire, treated with modified Eight Flavor Pill."