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Urology  (Expert Forum)
 | 
Pea sized Knot and no erection
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.

Pea sized Knot and no erection

by Always Something, Mar 11, 2003 12:00AM
I have noticed lately that my husband's erections have been little to nothing.  Last night he could not even obtain one.  After laying there for awhile we felt an abnormality in his left testicle that felt like a little knot attatched to what I assume is his tubes inside his left testicle.  Does this make sense.  He is only 38, and I guess I understand his erections at some point are not going to be what they always have been, but I am concerned if there is a problem.  I asked him this morning if he was going to get it checked out and he said no he just thinks it has always been there and he just never noticed.  The knot seems kinda hard and soft, it's hard to explain, and it seems to move around, but always attached to the tubes.  Am I making any sense?  Is this normal?

Thank you!

by Kevin Pho, MD, Mar 11, 2003 12:00AM
Hello - thanks for asking your question.

There are many causes for male impotence.  The evaluation should be undertaken in conjunction with your personal physician.

Psychological and emotional factors - Depression, performance anxiety, and lack of sensate focus are readily identifiable psychologic causes of impotence.

Hormonal abnormalities - Testosterone deficiency causes impotence and is corrected with testosterone treatment.

Autonomic neuropathy — Autonomic neuropathy, especially as a complication of diabetes mellitus, is an important cause of sexual dysfunction.

Vascular insufficiency - Vascular insufficiency may arise due to atherosclerosis with obstruction of major arteries or to small vessel (arterioles) disease found in diabetics.

Drugs — A number of drugs or other chemical substances can impede normal sexual functioning. Excessive alcohol consumption is the most common offender. Other recreational substances including marijuana, cocaine, and heroin also can lead to sexual dysfunction.

Any scrotal mass needs to be further evaluated.  There are many causes including varicoceles (dilation of the spermatic veins), scrotal cysts and testicular cancer.  A scrotal ultrasound for further evaluation is absolutely indicated.

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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