Pain in Prostate / Numbness Upon

I have a slightly enlarged prostate per my urologist and no sign of infection. My testosterone levels are normal but on the lower range. 250-275 or so. I do have BPH symptoms which seem harsher than my prostate size would indicate per my doctors. In the last year I have had more sexual dysfunction and need Levitra to stay erect consistently. If I masterbate, I have to do it hard to stay hard and ejaculate. When I ejaculate now, it feels numb and aches afterwards. On the Levtira, sometimes I can hardly feel myself cumming. My doctor said to stop drinking diet cola as the caffeine will make my bladder malfunction and increase the BPH symptoms. When I urinate on a full bladder, I usually have a "dead spot" ie numbness for a bit. That has carried over to my ejaculatons. The Pain and lack of feeling is bothersome and new. Would it make sense to see a neurologist and/or endocrinologist? I did go to an ED doctor and he said my blood flow was just about normal. Doppler test. But then why the dysfunction. flomax was of little help. Seemed to acutally make it worse. Do you think prostate massages would help?

[Kevin Pho, MD]

You can consider an evaluation for systemic diseases, like diabetes or thyroid dysfunction.  These can be evaluated for by simple blood tests.

A negative doppler ultrasound would make anatomical abnormalities or blood flow problems less likely.

You can be evaluated for prostatic infection - which can lead to the symptoms you are having.  This can include a transrectal ultrasound to image the prostate as well as urine testing.  

If the testing continues to be negative, it would not be a bad idea to be evaluated by a neurologist to rule out nerve dysfunction.

These options can be discussed with your personal physician.

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.

Kevin, M.D.
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