Penils Nerve Damage

[concernedguy]

Please refer this question to the Neurology forum if appropriate. I had three cysts removed from the underside of my penis using liquid nitrogen that was unfortunately liberally applied, it basically burned off one inch width line right under the head of the penis from one side to the other across the frenulum on the underside (a previously very sensitive area). After 5 days of extreme pain from the treatment I awoke with numbness in the area. Since 2 months the area has gone from scarred numbness (where I could feel the scar from the inside out) to a general numbness in the skin. I can no longer feel anything in that area of my penis from the inside out. I can feel touch with no sensitivity or sensation. Strangely the skin healed really nicely and there doesn't appear to be a visible scar unless it is closely inspected. I believe I have suffered severe nerve damage. The skin of the frenulum (circumscized) is now about half as long as it was before. Also the penis hangs down loose now where it used to be mugh tighter when flaccid. I occasionally get weak erections at night, and am able to get an erection only by direct manual stimulation now. There is no sensation in my penis, and I must vigorously masterbate for a long time to reach orgasm, which has little pleasure to it. I don't ever get physically aroused because I cannot feel anything on the underside of the penis. I frequently touch myself there just to know that I still have a penis! I have been tested for testosterone, glocose, and various other urine and blood tests which have all come out normal. I have been told that the large nerves below the skin in the area are intact. My desire is the same, but physically it is a problem. My qestions are:

1) Will this skin nerve damage worsen or improve over time?

2) I'm not open to any pumps or installed devices (I'm a 29 yr old) to have a sex life, but would take any medication or physical therapy to improve this, is there anything that can bring back some feeling, topical creams, prescriptions?

3) I am being seen by an excellent family physician now who has put me on anti-depressants and anxiety medication to remove the emotional aspect. Should I see a neurologist about this problem? I have seen a urologist who's only advice was that I've lost some sensation and that it will improve in time. (I was hoping to get married in this lifetime, so time is an issue).

4) I have read some research articles about success using nerve and human growth hormone, stem cells and certain amino acids to imrprove nerve damage, is there any hope out there at all for someone with penile skin nerve damage? Any specific surgery, transplant or treatment to dissolve the underlying scar and bring back some sensation?

5) Any general health reccomendations to improve things would be welcome, i.e. massage, diet, anything...

Concerned Guy

[Kevin Pho, MD]

1) One test to measure nerve damage to the penis would be a bulbocavernosus reflex test.  The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus.  More specific testing would be arranged via a neurologist who can do electrodiagnostic testing.  Unfortunately if there is nerve damage, it is unlikely that the feeling would come back to its original state.  

2) I am unaware of any specific medications to increase sensation once there is nerve damage.  If you are having pain or discomfort, there are medications that can treat the neuropathy (i.e. neurontin or tricyclic antidepressants).

3) I would strongly suggest a referral to a neurologist if you continue to have symptoms.

4) Again, I am unaware of any consensus studies where nerve and growth hormone is used in this instance.  However, a referral to a neurologist can better answer this question.

5) I would make sure that there are no associated conditions that can worsen any type of neuropathy - diabetes for instance.  

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.

[surgeon]

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[Nabu822]

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[rodger]

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[brogie]

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[brogie]

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[thirlstane]

A related discussion, Damage to nerves in head of penis? was started.