Am I really seeing things?
Q: I am 87 and reasonably healthy, both physically and mentally, though I am beginning to doubt the latter. Recently I have been experiencing hallucinations, triggered by a light being switched on in a darkened room. I see outlines of one or more figures, usually active, projected onto a wall. Am I going mad?
A: These are visual hallucinations. Hallucinations can occur in any of the senses (hearing, taste or smell for example) and one of the important features is that you are aware that they are abnormal events. If you lacked that insight and attached significance to them then they would be classified as delusions. There are a wide variety of causes and they can also occur with no cause in normal people. For example some people experience them regularly whilst dropping off to sleep (hypnagogic hallucinations). They are associated with some mental illnesses such as schizophrenia, alcohol use and abuse, some drugs, brain diseases such as Parkinson's disease, dementia and epilepsy to name just a few. Some detective work will be required to determine whether they are innocent or indicate underlying disease so I suggest you visit your GP for an assessment.
What causes a bend in the penis?
Q: My 60-year-old partner has had a pronounced bend in his erect penis for the past three months. He is very fit and active, has no health problems and is not on any medication. Is this anything to worry about? What causes it and is there any treatment?
A: This is Peyronie’s disease, where scarring occurs in the shaft of the penis. The scarred areas do not stretch like normal penile tissue, so the shape is distorted during an erection, frequently the scarred plaques can be felt within the penis. It is quite common with about 5% of men affected and is commoner in the over-50s. Many men live with it without any treatment or disruption to their life or sex life and only tends to be a problem if it is severe.
The cause is poorly understood, it may be related to minor trauma to the penis or blood leakage during an erection. It has no other significance but is commoner in people with diabetes or hypertension.
There are treatments available but they do not help all cases and there are surgical treatments too, but these are only used in severe cases. If you want to consider treatment you would need to see a urologist with experience of the condition.