Re: impotence

Posted By HFHS M.D.-MS on February 04, 1998 at 18:15:42:

In Reply to: impotence posted by Davey on February 04, 1998 at 15:36:01:








About 8 years ago I awoke with a painful erection which got worse until something "snapped" inside the penis which then curved to almost 90 degree angle and finally became flaccid.  Since that time I have never been able to achieve satisfactory erections and at present am unable to have intercourse.  The slight erections I do achieve dissipate quickly and are accompanied by a feeling of numbness in the penis, the testicles and scrotum.  I have consulted several urologists without any success.  The present recommended treatment is use of Trazadone and Muse, neither of which helps at all.
Based on the above information, can you give a likely diagnosis?  Is there a surgical intervention that is likely to help me?  I am desperate as I have no satisfactory outlet for sexual feelings.  My wife is sympathetic to problem but we have become emotional strangers.
Davey



        


Dear Davey:
Thanks for your question.
Most patient histories regarding penile fracture occur during intercourse and the snap is heard with quick detumessence ( becomes flaccid) of the penis. The penis is usually bent and there may be bruising along the shaft.  Few have awoken later and noticed the swelling, bruising and curvature.
If  these patients present to the ER, they  undergo immediate surgical repair closing the communication  between the artery ( the blood vessel bring blood to the penis) and the venules ( vessels taking blood away from the penis ).  The fracture made  a bypass of the erection mechanism which normally allows the penis to store blood at high pressures during erection.  I suggest seeing a Urologist.  He will probably inject medicine into  the penis to see if the erection mechanism is still bypassed. If so, he may order some Xrays to plan for operative repair or refer you to a Urologist who specializes in traumatic penile injuries.
If you get a normal erection with the injection, the cause of your impotence is probably not related to this episode.  
As for your sexual release and desire for sexual intimacy, orgasm is possible without erection.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
Good luck.    
HFHS M.D.- MS
*Keyword: Traumatic Penile Fracture