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Urology  (Expert Forum)
 | 
28 year old male with Real Impotence
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

28 year old male with Real Impotence

by stevej, Jul 02, 2003 12:00AM
I'm 28 years old male, I just need your advice Please!!



About 4 years ago a pain started in the whole length of my penis in the erectile tissue every time I had an erection. Every time I came, my erection went down, but my penis would hurt, the pain was like being bruised, then badly bruised as time went on, and it stayed small and hard for longer and longer, up to days later.



Each time I had an erection the pain got worse. As the blood started to flow in the penis the pain would start, it was like very bad pins and needles, getting more painful and it would hurt to masturbate. Over a couple of months the pain got worse and worse, until I couldn't touch it. My penis constantly hurt all the time (when normal and erect) and it was very painful to touch or even to wear cloth, and this carried on for about a year. Then after this, my penis became small in size, and hard (just like after your have ***) but stayed like this ALL the time, for well over a year. Then in about year 2, my penis loosened up and start to go to normal length when normal, but still alittle hard.



I have had an ultra scan and the doc said the blood flowing in was fine, but it seemed to flow out to fast. Maybe blood shunting, and maybe a faulty valve too. I have had courses of viagra and this has given me an full erection for only a few seconds if I tense my penis when masturbating, but when left, goes down straight away.





Now, with hours of masturbation and full concentration, I can only stay hard for about 1 second (Some times!), then it start to go down, and it gone within a 30 second. My penis has gone back to normal size now, but still is hardish to touch.





EXTRA INFO



I have no hang-ups about sex, I loved doing it, and was very good at it.



I have no mental problems or illness, this is the only thing wrong with me.



I don't smoke or take any drugs



I am not stressed or depressed, Yet!



I never get a morning erection any more ether.



I don't know if this helps, but before the problem I have had some periods of very little or none masturbation (e.g. once a month). And then periods of masturbation for long periods of time (e.g. 1 - 5 or more hour  "may I have burnt out the erectile tissue"



To have the ultra scan, my penis was injected to make it hard. As I started to get the erection. My penis started to become very painful, like it did when things started to go wrong, and it was to painful to touch.



QUESTION

Because when my penis was injected to make it stiff for the ultra scan, and because the pain came back when it started to go wrong. "Do you think that other injections would correct the damage."



"Is their a cure, and can you give me any advice so I can pass it on to the doctors over here, so I can have a future."



I am seeing Urology again at the end of this month and I need something to help them. Please pass my info on, if your not sure what it is.



Thank you



P.S. Sorry about the bad English.



If you need to contact me my email is

***@****

by Kevin Pho, MD, Jul 03, 2003 12:00AM
Hello - thanks for asking your question.



Without examining you, it is impossible to say what you have.  Here are some thoughts.



There are several considerations, including anatomical abnormalities, testosterone deficiency, psychological stresses, or deficiencies in the blood vessels.  



To evaluate for this, you have already had an ultrasound which demonstrated adequate penile blood flow.  I would suggest having a testosterone test to make sure the levels are within normal range.



The more definitive test would be nocturnal penile tumescence testing.  This is a test that can quantify the number, tumescence and rigidity of erectile episodes a man experiences as he sleeps.  Results from this test can determine whether there is a surgical solution or not.  



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.
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