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Urology (Expert Forum)
Re: Long post - Penile Curvature( not peyronie)and recent lumps and Thrombosed Vein
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.
Re: Long post - Penile Curvature( not peyronie)and recent lumps and Thrombosed Vein
by HFH-MD-MS, Jan 01, 1995 12:00AM
Posted By HFH M.D.-MS on January 29, 1998 at 01:35:25:
In Reply to: Long post - Penile Curvature( not peyronie)and recent lumps and Thrombosed Vein posted by stm on January 13, 1998 at 16:02:01:
: I think it may be easiest to simply explain my problems since
I don't even know where to begin.
I am in my mid 20's.
For as long as I can remember, I have had problems with my erections.
When I get an erection, my penis points straight up towards the ceiling and
stands perfectly parallel to my stomach( almost to the point of hugging the abdomen).
In addition, there is a slight bending of the penis in towards me.While I recognize that erections come in a variety of shapes and bends, I seem to have a frustrating problem with mine.. Any attempt to have intercourse requires that I push the penis down in order to achieve penetration. Unfortunately, this causes grave discomfort at the base of the penis. I can push it down a little bit and then I start to experience that strong pain at the base. The presence of the inward curvature further frustrates attempts to achieve
easy penetration. As a result, I cannot easily or comfortably have intercourse in any position with a full erection
because of the configuration of my erections and the pain experienced upon
trying to lower my erect penis so that it is perpindicular to the body. I have been able to penetrate with partial erections since they are more elastic.Yet,
such encounters are satisfying to neither party. Moreover,in such an instance,it is inevitable that I will soon achieve a full erection that will
be painful at the base, almost as if I am doing something unnatural to the penis.
Over the years, I have visited a few urologists who seemed at pains to confidently diagnose the problem.
Upon cursory examination of the flaccid penis and snapshots of the erect penis, one stated that my problems may be attributable to an abnormally small tendon at the base of the penis that was causing the restrictive
feelings of strain in that area. Another surmised that the problem might be a tight ligament.
None of the doctors ever seemed quite sure, nor did they do any testing of any sort( beyond looking at my limp penis and polaroids of
my erections). Needless to say, their tentativeness made me less than confident about their surgical
recommendations.Yet,
all seemed quite certain that my problem was not Peyronie's Disease ( can
they be sure of this without examining
the erection first hand ). I would really like to resolve this problem soon
as it has inordinately
complicated my life.
Unfortunately, my problems have recently gotten worse. In trying to gently push the penis
away from the abdomen in order to attempt intercourse,
I have suffered some trauma to the penis. Two months ago I developed a
thrombosed vein on the shaft of the penis. The clot has been causing me great
discomfort, especially when it comes into the slightest contact with anything else.
At this point, it shows no signs of improvement.
Around the same time I noticed some hard lumps on the right side
Of the penis that hurt when I touch them. There is also anow a pronounced
vein which runs along the shaft of the penis which causes also discomfort upon contact.
I would be extremely grateful if you could offer me any suggestions or information . Will the thrombosis
heal on its own ? What could these new lumps be(is it
part of the same trauma that caused the thrombosed vein ? )
Is my curvature problem reparable without surgery ?
Could I have a tight suspensory ligament ?
-------------------------------------------------------------------------------
Dear STM
Thank you for your questions.
Question # 1
There is a condition which may exist from birth called dorsal chordee which results in an upward bend of the penis with erections. Your description does not completely match this problem but must be a consideration.
To diagnose Peyronies disease, the penis usually has a curvature when erect and there is scar tissue along the shaft of the penis on the same side as the curvature. The scar can be best felt or palpated when the penis is flaccid (not erect). Peyronies maybe associated with injury or may occur spontaneously.
The trajectory of the fully erect penis is due in part to the suspensory ligament which usually relaxes with age. A tight suspensory ligament is not a common problem. A Medline search from 1994 to the present has only a few articles regarding the repair of the ligament and then after trauma or in association with the repair of congenital abnormalities.
The quality of the erection plays an important role, also. Some surgeons cut this ligament during the insertion opf a penile prosthesis for the treatment of impotence to give the apppearance of a longer phallus (penis). There is some argument against this practice in patients with healthy erections in that these patients may need this support as they age and the quality of their erections decrease.
All of the treatments for significant unsatisfactory penile angulation invovle surgery.
In regards to your other questions:
Have you been examined by your Urologist to diagnose your thrombosed vein? Do you have normal erections since noticing the vein? The reason I ask is there are other conditions which may resemble a thrombosed vein. Other causes are usually easy to sort out by examination and a detailed trauma history. Also the new lumps are hard to diagnose without an examination by a Urologist.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital and its satellites
(i-800-653-6568).
Sincerely
HFHS MD M.S.
*keyword: Penile Suspensory Ligament, Peyronies Disease
In Reply to: Long post - Penile Curvature( not peyronie)and recent lumps and Thrombosed Vein posted by stm on January 13, 1998 at 16:02:01:
: I think it may be easiest to simply explain my problems since
I don't even know where to begin.
I am in my mid 20's.
For as long as I can remember, I have had problems with my erections.
When I get an erection, my penis points straight up towards the ceiling and
stands perfectly parallel to my stomach( almost to the point of hugging the abdomen).
In addition, there is a slight bending of the penis in towards me.While I recognize that erections come in a variety of shapes and bends, I seem to have a frustrating problem with mine.. Any attempt to have intercourse requires that I push the penis down in order to achieve penetration. Unfortunately, this causes grave discomfort at the base of the penis. I can push it down a little bit and then I start to experience that strong pain at the base. The presence of the inward curvature further frustrates attempts to achieve
easy penetration. As a result, I cannot easily or comfortably have intercourse in any position with a full erection
because of the configuration of my erections and the pain experienced upon
trying to lower my erect penis so that it is perpindicular to the body. I have been able to penetrate with partial erections since they are more elastic.Yet,
such encounters are satisfying to neither party. Moreover,in such an instance,it is inevitable that I will soon achieve a full erection that will
be painful at the base, almost as if I am doing something unnatural to the penis.
Over the years, I have visited a few urologists who seemed at pains to confidently diagnose the problem.
Upon cursory examination of the flaccid penis and snapshots of the erect penis, one stated that my problems may be attributable to an abnormally small tendon at the base of the penis that was causing the restrictive
feelings of strain in that area. Another surmised that the problem might be a tight ligament.
None of the doctors ever seemed quite sure, nor did they do any testing of any sort( beyond looking at my limp penis and polaroids of
my erections). Needless to say, their tentativeness made me less than confident about their surgical
recommendations.Yet,
all seemed quite certain that my problem was not Peyronie's Disease ( can
they be sure of this without examining
the erection first hand ). I would really like to resolve this problem soon
as it has inordinately
complicated my life.
Unfortunately, my problems have recently gotten worse. In trying to gently push the penis
away from the abdomen in order to attempt intercourse,
I have suffered some trauma to the penis. Two months ago I developed a
thrombosed vein on the shaft of the penis. The clot has been causing me great
discomfort, especially when it comes into the slightest contact with anything else.
At this point, it shows no signs of improvement.
Around the same time I noticed some hard lumps on the right side
Of the penis that hurt when I touch them. There is also anow a pronounced
vein which runs along the shaft of the penis which causes also discomfort upon contact.
I would be extremely grateful if you could offer me any suggestions or information . Will the thrombosis
heal on its own ? What could these new lumps be(is it
part of the same trauma that caused the thrombosed vein ? )
Is my curvature problem reparable without surgery ?
Could I have a tight suspensory ligament ?
-------------------------------------------------------------------------------
Dear STM
Thank you for your questions.
Question # 1
There is a condition which may exist from birth called dorsal chordee which results in an upward bend of the penis with erections. Your description does not completely match this problem but must be a consideration.
To diagnose Peyronies disease, the penis usually has a curvature when erect and there is scar tissue along the shaft of the penis on the same side as the curvature. The scar can be best felt or palpated when the penis is flaccid (not erect). Peyronies maybe associated with injury or may occur spontaneously.
The trajectory of the fully erect penis is due in part to the suspensory ligament which usually relaxes with age. A tight suspensory ligament is not a common problem. A Medline search from 1994 to the present has only a few articles regarding the repair of the ligament and then after trauma or in association with the repair of congenital abnormalities.
The quality of the erection plays an important role, also. Some surgeons cut this ligament during the insertion opf a penile prosthesis for the treatment of impotence to give the apppearance of a longer phallus (penis). There is some argument against this practice in patients with healthy erections in that these patients may need this support as they age and the quality of their erections decrease.
All of the treatments for significant unsatisfactory penile angulation invovle surgery.
In regards to your other questions:
Have you been examined by your Urologist to diagnose your thrombosed vein? Do you have normal erections since noticing the vein? The reason I ask is there are other conditions which may resemble a thrombosed vein. Other causes are usually easy to sort out by examination and a detailed trauma history. Also the new lumps are hard to diagnose without an examination by a Urologist.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital and its satellites
(i-800-653-6568).
Sincerely
HFHS MD M.S.
*keyword: Penile Suspensory Ligament, Peyronies Disease
