Here's Doc's Experience with his PA:
All good questions and hope this helps. I put my PA in 25 years ago, myself. Keep in mind that it is a foreign body and early on the meatus can become irritated and swolen on occasion. Avert this by not stroking over the top of the head of your cock for a time and when you do, use a moisturizing lube. Albolene is great. Right after insertion, treat the piercing like a puncture wound and keep it clean. Early on, the jewelry can cause more sensitivity and can even feel uncomfortable if it rotates into an awkward position or rubs vigorously against the soft tissue of the meatus. In time, these "ouch moments" will become fewer but in fact they never go away. A bent barbell is often a good remedy for daily wear as they are comfortable and do not put excess tension on the meatus. The drawback is that it can slip into the urethra unless the ball is large or the meatus is not overly large. The meatus....piss slit.... will stretch over time as well. Foreskins don't have much effect on the PA and I find that it keeps the jewelry in a comfortable position. Lots of uncut men sport PAs and experience few problems. When masturbating, however, some men can irritate the foreskin if it is tight or pulled too vigorously over the head and the PA. That too will diminish in time. One of the most common issues observed is attempting to stretch the PA too fast or vigorously which will tear the piercing and can form scar tissue, inhibiting insertion of a larger piece of jewlry but will not prevent it. Stretching through scar tissue is a bit more painful and yes, stretching the PA can be painful. It is worth it, however. The weight on the head of your penis is delightful and a constant reminder that your friend is pulling on the head of your cock. Spontaneous erections are not uncommon even after 25 years. I'm wearing a 00 gauge although I never imagined I would go this large. Yes, it is an impressive sight. Straight and gay men find themselves looking at it. Do women like a PA on their man? Some do, some don't. Many say that it feels incredible.
Bruising or lacerations can occur if stroking too forcefully without taking into consideration that the penis is "soft tissue". While tugging on the PA is nice, keep in mind that the bridge between the meatus and the piercing can be torn. No one wants that to happen. The bridge can diminish over time as the meatus stretches and larger gauges are inserted. For guys that never up-gauge, this does not appear to be a problem. A good piercer will know to place the piercing far enough below the coronal ring. Wear good grade jewelry. If swelling or pain becomes an issue, seek counsel from a physician. Trust me, we have seen them. Infections can occur as a result of poor quality jewelry which might scratch or cut the meatus or urethra.
While the PA is a personal decision, so is the sensation. Yes, it feels great when you stroke and it feels different, especially if your technique includes going over your cock head. Yes, you learn to stroke differently. Be aware that a PA can inhibit some of those incredible distance shots some men can achieve. After all, there is an obstruction in the urethra. As one up-gages, ejaculation tends to ooze rapidly rather then squirt. Taking the PA out can reverse this somewhat. Yes, as the piercing grows larger, piss and cum will emerge from the piercing. One learns to gently cover the piercing or turn your cock over to prevent pissing down your leg or wetting the front of your trousers. Just practice. Yes, sitting down to piss when at home is very nice. No accidents and no thought required. How soon after you have a PA installed will you be able to stroke your cock? That all depends on the vigor of your stroke, your technique, tolerance for discomfort and how fast you can find a place to take your cock out. I generally suggest at least a day. Let the guy rest. Someone just stuck a needle in him! Urinating in fact acts as a healing factor providing one does not have urinary tract infection. If that is the case the PA should not be installed until the infection has been treated and eliminated.
Sensation on the cock head is enhanced for some, like me, whether stroking or fucking. Yes, you can fuck with the PA in. Many bottoms love it. Some will ask you to remove it. I like the look of a PA. It's visually stimulting! I like the idea that in a room of 50 men, I may well be the only guy there with a PA. I like the stares at the gym and the surprise when I drop my drawers after meeting a new date. Occasionally I remove it when I want some vigorous cock play or another man is jacking me off. He might not know how to keep from hurting my cock. The way to take care of that is tell him what is right and feels good. Again, a bent barbell is great for masturbation. Yes I can feel the PA tap the prostate when I top a man and I can also feel the wonderful sensation when I am stroking myself or another hand is helping me out. If there is any bleeding or long term discomfort have it checked and keep that thing out of someone's mouth... male or female if there appears to be any irritation as it could indicate some open tissue. The human mouth carries more harmful bacteria than most dogs. Most inflamation issues can be treated with a warm bath, some epson salts or a bit of triple antiobiotic ointment.
Take care of your PA just like you take care of the finger on which you placed a nice ring. The PA will become just as much a part of you as that familiar ring on your finger and being without it is extremely noticeable.