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Urology (Expert Forum)
Prolonged nocturnal erections - increasing problems
Answered by
Stephen Liroff, MD - Urology, Pediatric Urology, Peyronie’s disease
Vattikuti Urology Institute, Henry Ford Hospital
West Bloomfield - MI
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.
Prolonged nocturnal erections - increasing problems
by northward, Jul 22, 2009 01:45PM
I've asked you before, and your answer gave sense, but the problems are still there and seem to increase.
The problem is still the same: repeated nocturnal erections that sometimes are regular, but later at night these erections doesn't seem to go all down, instead the erections seem to stay at a partial state. Recently I have woken up by this, noticing that I have an erection, but the penis won't get up, it lays down even if its almost at full erections. It seems that I have very little control of this kind of erections, also the head is flaccid, unlike normal erections when it is filled in my case, and they stay like this for what seems to be hours. The latter kind of erection goes down very slowly, and almost not when I'm still half-asleep. However, it goes down when I am fully awake and get up of bed in morning. I have few problems during the day. I only take any 2x0.25 mg Diazepam a week, which I need to function for my Dystonia, e.g. to avoid getting tremors all day.
What can this be? I fear "stuttering priapism", even if you said it is not the case, and a urologist I went to see said it is nothing to worry about. I dont have pain, but sometimes get a numb feeling in the penis. Also it is more difficult to get an erection when masturbating, as compared with before, and it has been like that since december. It takes a lot of stimulation to get the penis to stand up, often it helps if I contract the pelvic muscles. The penis is more blood filled in flaccid state than before, and is also firmer than before, although not uncomfortable. I got Cialis from the urologist, but I dont take it because of fear for side effects. My neurologist hasn't heard of ED as side effect of Dystonia.
I fear loosing potency over this. I would be very grateful for any thoughts what it may be and what to do next. (I've received tip on staying off chocolate, caffeine and citrus, and seing another urologist of course)
Thank you so much for your answer Sir.
The problem is still the same: repeated nocturnal erections that sometimes are regular, but later at night these erections doesn't seem to go all down, instead the erections seem to stay at a partial state. Recently I have woken up by this, noticing that I have an erection, but the penis won't get up, it lays down even if its almost at full erections. It seems that I have very little control of this kind of erections, also the head is flaccid, unlike normal erections when it is filled in my case, and they stay like this for what seems to be hours. The latter kind of erection goes down very slowly, and almost not when I'm still half-asleep. However, it goes down when I am fully awake and get up of bed in morning. I have few problems during the day. I only take any 2x0.25 mg Diazepam a week, which I need to function for my Dystonia, e.g. to avoid getting tremors all day.
What can this be? I fear "stuttering priapism", even if you said it is not the case, and a urologist I went to see said it is nothing to worry about. I dont have pain, but sometimes get a numb feeling in the penis. Also it is more difficult to get an erection when masturbating, as compared with before, and it has been like that since december. It takes a lot of stimulation to get the penis to stand up, often it helps if I contract the pelvic muscles. The penis is more blood filled in flaccid state than before, and is also firmer than before, although not uncomfortable. I got Cialis from the urologist, but I dont take it because of fear for side effects. My neurologist hasn't heard of ED as side effect of Dystonia.
I fear loosing potency over this. I would be very grateful for any thoughts what it may be and what to do next. (I've received tip on staying off chocolate, caffeine and citrus, and seing another urologist of course)
Thank you so much for your answer Sir.
Doctor's Answer
by Stephen Liroff, MD, Jul 23, 2009 12:21AM
, Jul 23, 2009 12:21AM
From your description, it sounds as though you are experiencing partial erections with a feeling of a full erection upon awakening. Then, when you want to have sexual activity you can obtain adequate erections though you feel as though the glans turgidity is not what you remember/would like.
I still do not feel that there is a serious physical issue but a penile Doppler ultrasound by someone familiar with them, especially involving a prostaglandin E-1 injection may set your mind at ease.
You’ll need to find a urologist who specializes in sexual dysfunction, not one of the contract groups that have sprung-up around the country to deal with erectile dysfunction.
If this study is normal, you need to stop obsessing over this. A sex counselor may then be quite helpful.
S.A.Liroff, M.D.
I still do not feel that there is a serious physical issue but a penile Doppler ultrasound by someone familiar with them, especially involving a prostaglandin E-1 injection may set your mind at ease.
You’ll need to find a urologist who specializes in sexual dysfunction, not one of the contract groups that have sprung-up around the country to deal with erectile dysfunction.
If this study is normal, you need to stop obsessing over this. A sex counselor may then be quite helpful.
S.A.Liroff, M.D.
