Dear Mitch,
Erectile dysfunction may be caused by psychological problems, neurogenic dysfunction, hormonal alterations, or compromised blood flow, or venous leak. In your case, the later 2 problems, compromised blood flow and venous leak, may be present. I still would not rule out peyronies disease as a cause for your unilateral erectile dysfunctionm but I am unable to evaluate you personally, so I must leave it as a possibility (common things are common). You may have a proximal plaque at the base of the penis which cannot be fully evaluated. The most common cause in a 24 year old, would be some sort of trauma. However, what we do know about penile the anatomy, would indicate that the connection or communication between the pair of corpora cavernosa in your situation must be altered. An open communication would allow for equal pressures to accumulate in the paired erectile bodies and would not allow one side to become erect without the other. Either a history of penile trauma, sludging of red blood cells with scarring from diseases such as sickle cell, or leukemia, may be responsible for the physiology you explain. Another thought would a vascular (venous) leak at the base of the penis. Again this could result from trauma or a fracture of the corpora cavernosa with aberrant healing.
The best thing for you to do is see a urologist. He or she can get a full history and examine your condition. They are knowledgeable in the area of erections and can suggest diagnostic tests that may identify a problem. In terms of this being primary cancer of the penis, I would have to say this is very unlikely. The insensitive areas could also be explained by scarring after penile trauma or peyronies disease.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Erectile dysfunction