Penis size reduction (both flaccid and erect) and urinary issues

Up until I was about 27 years old, I had a very large penis with above average thickness.  I never measured it but judging by what I've lost I estimate it was about 9" long and probably 6" around (now: 7.75" long, 5.25" thick).  Around age 27 I began to see changes.  Over the next 6 years I have noticed quite a few gradual changes (I'm now 33 years old):

- A standard condom, unrolled all the way, would still leave about 1.5" of bare skin at the base of my penis.  Now unrolled all the way it ends up right at the base.

- I used to hit the cervix OFTEN of the partner I was with.  Sometimes this was good, sometimes not, but it happened in virtually every sexual encounter.  Now I may hit the cervix in certain positions but it's rare.

- My penis head used to be large enough that some women had a hard time putting their mouth around the head of my penis to give me oral sex.  Now my head is a lot smaller.

- My shaft and head used to be rock hard and it was very easy to obtain an erection.  While flaccid my penis was quite long and I'd often have to hold it a certain way when sitting on a toilet so it didn't hit the bottom of the bowl.  I don't have any problem now, per se, getting an erection but it is a bit harder without a partner and is definitely nowhere near as rock hard.  It's smaller both both flaccid and erect.  

- I have pain at times in my groin, primarily on the right side and I've had urination problems.  The pain is dull and seems like something in my groin rather than my scrotum or testicles.  The urination issue is a weak stream that does not turn on or off nearly as automatically as before.  

- Sometimes I'll also notice that the head of my penis is cold to touch and makes me think enough blood is not getting to it.  This is only when it's flaccid, but never used to happen.

- I had a significant upward curvature previously but now it is much less pronounced.

History with urologists:

  * testosterone (above average levels)
  * ultrasound twice (totally normal)
  * urine flow test (flow was below normal for my age - 33yrs old)
  * prostate finger test (multiple - all normal)
  * Flomax (minimal help, stopped after short time)
  * tried Viagra, Cialis (gave me extra .25" in girth but overall was disappointing)

Diagnoses:

1.  I was told that my prostate seems normal so it is likely that I am tightening the muscles around my bladder, causing my urination difficulties.  This diagnosis had nothing to say about my penis size.

2.  My very large size, coupled with certain sexual positions, could have damaged the corpus cavernosum causing degradation of blood supply.  I do recall sex with partners where I felt discomfort and put my partner's pleasure over my enjoyment.  This seems plausible to me.

Questions:

1.  Do either of these seems plausible?  Or another possibility?

2.  If either one of these (particularly #2 above), is there anything I can do?

Thank you in advance.

Stan

[Kevin Pho, MD]

To answer your questions:
1) Either scenario is possible.  The tests that you have done already - including penile ultrasounds - would make major diseases, including blood flow disorders, less likely.  You can further evaluate the prostate with a transrectal ultrasound, or image the GU area with a pelvic CT scan.

2) If there was a problem with blood flow or supply, this would have been seen on the ultrasound.  Another urologic opinion can be sought - preferably at a major academic medical center.

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.
kevinmd_

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