This update is offered for anyone considering getting pierced for a PA. An earlier report ("Conservative Approach to a PA") is posted at http://www.bmezine.com/pierce/09-male/pa/A40112/paconser.html
At A Glance Author anonymous When Two years ago Artist Cannon Studio Acme Location Cincinnati, OH Bottom line first: I still love my PA, my only piercing, and I have never regretted getting my penis pierced. I followed aftercare instructions, and my piercing healed fast and has never given me any medical problems. If you take your time to make sure it is what you really want, choose a professional piercer with good hygiene, and plan for your ring to be permanent, there appears to be no good reason not to get one. Forget about whether the needle will hurt; even if it hurt a lot - which it doesn't - it would be for just a tiny fraction of the coming decades of wearing your ring.
I talked it over with my family physician and my urologist before I even mentioned the idea of a PA to my wife. My family physician expressed concern about possible urinary tract infection (I have never had one), but my urologist gave me the "go-ahead" without batting an eye. Then I talked it over with my wife, and I waited for four years until she became sufficiently comfortable with the idea that she proposed that I go ahead with the piercing. During that wait, for two years I wore a 10 gauge ring 24/7 as a PA without the bead. Removing the small bead left a small gap in the ring, and evidently the open end of the ring fitted securely into the wide place inside the urethra. Only rarely did the ring fall out, but my wife always removed my ring before intercourse so it wouldn't come out where it would be hard to retrieve!
At the end of every annual physical exam by my family physician, I wind up standing naked while he sits on a stool and examines my testicles and prostate. Now with scarcely a glance at my penis, he casually asks "No problems with your ring?" Since he has never seen another PA, he remarked "We're learning about this together."
Some thoughts based on my experience:
1) The novelty will wear off.
Don't get pierced to shock or impress someone. At least in conservative Ohio, the fad for getting pierced has already passed its peak, and you can't count on shocking anybody now that body piercing has gone mainstream. In the gym shower room, no one has ever commented or even raised an eyebrow about the ring hanging out of the end of my penis. One thing I've done that's unusual is to work for three years as a nude model at the local art academy. Of dozens of art students who saw my ring, only one, a freshman boy, recoiled in shock. I got three interested questions, but among dozens of artists who included my penis in their drawings, only four (including the shocked boy) ever drew its ring.
2) There will be some largest ring size appropriate for you.
There is no international contest to see who can hang the biggest ring through his penis. Consider your partner's feelings. One piercer told me he had worked up to a 2 gauge PA, when his wife made him take it out as uncomfortable during intercourse. Go slow in upsizing, so you don't end up having to take out your ring and then ever afterward spray your testicles with pee from a big stretched hole in your urethra.
Cannon at Acme in Cincinnati pierced me for a 12 gauge PA, and after 10 months I went back to him for a 10 gauge ring, which I've worn for two years now. Even without the weight of a big ring pulling on it, my piercing eventually stretched. Though I went years with no urine leaks, recently I began getting enough leakage to wet the skin surface around the pierced hole. This small amount of urine is easily absorbed in my underpants. Cannon pierced me through the far end of the scar where my frenulum was cut off in circumcision, but the stretching has neatly split the scar into halves along its length. I see my urologist about once a year, and he always examines my penis. While inspecting my piercing, he noted how it has stretched and volunteered a suggestion: "You could put a larger ring in there now."
Originally I thought I'd like to wear a ring in my penis which would be the size of my wedding ring, about 8 gauge or 6 gauge. I still occasionally try to interest my wife in my wearing an 8 gauge circular barbell, and I suggest she might like to play with her tongue in the gap. But my 10 gauge ¾ inch ring is probably a pretty good size in proportion to my nearly average size penis (3 inches soft and 5 to 5 ½ inches erect). The 2-gauge piercer said most of his PA customers stay with 10 gauge.
3) Expect to sit to pee for the rest of your life.
Enthusiasts for the PA (including me) have reported many tricks for dealing with how the ring in your urethra disrupts the aim of your urine stream, so you can continue to stand to pee. Public urinals are fine, but still I routinely overshot the toilet at the beginning or end of a pee, and I got tired of wiping the bathroom floor. (You wouldn't ask your partner to clean up after you ...would you?) It is little more trouble to drop your pants than to just unzip your fly.
4) Pleasant Surprise:
My urethra has not become desensitized by the constant presence of the ring inside it. Though my wife originally worried that I would get hurt by being pierced, she now enjoys sending me through the roof by playing with my PA. The ring is great for foreplay: when my wife rotates the ring through my piercing, the sensation inside my penis is at least as strong as my sensation from intercourse. Do try letting her rub your penis ring against her clitoris as long as she likes, while you are not allowed to beg her to stop. You may be unable to keep yourself from coming all over her. I don't get any special sensation from playing with the ring myself when I masturbate, and neither of us can feel the 10 gauge ring during actual intercourse.
So if you think of the PA ring as mainly a decoration for your own amusement, and your partner is OK with it, I think you will like it. After years of wearing one, I still think it looks cool to see that silvery ring emerging from the hole in the end of my penis. I think your PA will continue to be an uncommon and distinctive body ornament for decades to come.