Hydraulic failure

Dear Sir/Madam,

Approximately a year ago I was involved in sexual intercourse with my girlfriend and I heard the dreaded 'pop' noise.  What became apparent was that my penis had suffered some sort of trauma.

The result was a distinct curvature to the left when flaccid, a lack of sensation, a lack of control when urinating, a lack of hardness with my erections, no erections at all in the morning and it is now a lot of hardwork to ejaculate.  There have even been occasions when I get these overpowering headaches that prevent me from continuing having sex.      

I immediately went to my GP who referred me to a urologist in Harley Street.  His diagnosis was that I had damaged one of the hydraulics and that in time everything would be back to normal. He also said that there would no harm in continuing sexual relations.

I have since been back twice to the same urologist and the diagnosis hasn't changed.  I realise that time is a healer but it is very difficult to put that in to practice when I can't see any improvement.  In fact I think things are getting worse.  

I am now very conscious, as is my girlfriend, that our sex life is in limbo until I can find a definite answer to my problem.  

I would be very grateful if you could shed some light on this and maybe point me in the right direction, if you pardon the pun.

I look forward to your comments.

Thanks and regards

[Kevin Pho, MD]

Most cases of penile trauma caused by sexual activity and most other minor penile injuries will heal without problems. However, complications can and do occur.

Possible complications include: infection, erectile dysfunction due to blockage of the nerve or blood supply to the penis, priapism in which the penis becomes erect and stays erect to the point of pain, fistula formation in which urine may leak out of the urethra and through the skin of the penis to the outside, curvature (chordee) of the penis after the injury has healed or major loss of skin, portion of the urethra or corpora cavernosum. Failure for the return of sufficient sexual function is dependent upon the degree of injury to the arteries, nerves and corpora cavernosum and whether the patient was experiencing erectile dysfunction just prior to the injury.

You may want to consider the following tests to determine the extent of the injuries: this might include an ultrasound of the penis, MRI or a special test called a cavernosogram. In the latter test, a thin hypodermic needle is inserted into one area of the penis before a radio contrast solution is injected and X-rays taken.

Today, the treatment of choice will probably be for the individual to undergo surgery since it has the best long-term results by lowering complication rates often linked to non-surgical approaches.

You may want to discuss this option with your urologist.

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.