This patient support community is for discussions relating to urology issues, benign prostate disease, penis curvature, cystisis, pediatric urology, prostate, sexual dysfunction and urological cancers.
superficial colles' fascia tear from stretching the flaccid penis. (pegym destrier)
-retracted, hard flaccid penis. resists stretching and remains seized up unless exposed to heat for a generous amount of time
-flaccid penis feels lighter, almost weightless at times
-reduced erection quality. harder to get erections and erections subside quickly without stimulation.
-tight, constricting feeling when erect
-slight reduction in erect length. often times slight reduction of girth.
-indentation on one side of penis, usually the left side. more pronounced when transitioning between flaccid and erect (getting a semi hard-on)
-reduced morning erections and spontaneous erections. morning erections are poor quality and can be very infrequent or never
-cold glans (glands) and scrotum
* all symptoms seem worse when in the standing position. everything seems to loosen up a bit and erections are better when sitting
Other Common Symptoms:
-reduced shaft sensitivity (penile numbness)
-penis head won't fill up during erections
-weird reaction of penis when flexing PC muscle (jerking motion rather than filling the penis with blood)
-tightness in perineum
-reduced sex drive
-difficulty urinating/ increased urge to urinate
-different feel to the skin in the genital area, softer and thinner
-reduced testicle size, joint pains, fatigue
Now let's talk about the causes of this condition. At least a few of these should sound familiar to you by now:
-stretching the flaccid penis causing a popping sensation at the base of the penis on one side, just inside the groin area (most common). This causes a frightening retraction of the penis into a small, hard and shriveled state
-injurey during sex or jelqing, can include the same popping feeling as above
-vigorous, prolonged masterbation (masturbation) session.
-injury to the perineum area or base of the penis
Right from the outset of my research, I have found that no one has had legitimate success with visiting a urologist. Ultrasound testing shows nothing out of the ordinary, and people are told that there is nothing wrong with them (or worse, it's in your head). I have not been to a doctor about this as I had no reason to suggest I would have any more success than the next guy (the symptoms of the condition are remarkably consistent among everyone afflicted)
How I made a mild improvement:
The overall tightness in the genital-perineum region seemed directly related to the severity of the symptoms. I found that my perineal muscles, such as the PC were chronically tense as if my body was bracing for the next trauma to the area. I focused on relaxing my pelvic floor for a night. It is tricky at first but gets easy with practice. Think of it like a reverse kegel, but don't put much force into it, just let the area kind of relax. It should feel like the entire region lowers and loosens a bit. This method will allow your penis and scrotum to hang a little lower and will improve erections a little. When sitting down, my erections feel more or less normal because the area is maximally relaxed. Problems continue when standing. This is no cure, but it helps and it did offer insight as to what the structural problem might be.
Nature of the problem:
Most of you are probably experts in male reproductive anatomy by now. I know that I have wasted countless hours trying to find anything that might hint at the cause of the problem. Let's consider the instance of injury by stretching. When stretching the flaccid penis, you are elongating several fascia. In order of deep to superficial they are the tunica albuginea, Buck's fascia, and Colle's fascia (continuous with the dartos tunic and the superficial fascia of the perineum, it is essentially one big sheet). Most people seem to think the problem is with the deeper fascia of the penis, and that there is an injury somewhere along the length of the penis. There isn't.
All of my searching has led me to conclude that the injury is to the superficial fascia of the perineum and penis, which are the same thing and can be referred to as Colles' fasica. The popping feeling many of us felt at the time of injury was this membrane tearing. The defensive retraction of the ruptured fascia is what caused and continuous to cause the constricted flaccid penis. This damaged fascia resists the tendency of the penis to loosen up when flaccid and to grow when erect. The change in appearance of the penis in the days and months following the injury is damage to the fragile tissue between colle's fascia and buck's fascia, known as areolar tissue.
Many people, including myself, complain of reduced "force" of erection, or the decreased resistance of the fully erect penis towards being pushed downwards. I think this is because of some loss of support form the fascia injury. Think of loss of tensile strength of a ripped cloth.
Why this is a more serious problem than you may think:
Besides the crappy erection quality, there are a lot of other negative things happening because of this simple injury. The fascia of the pernial region are more or less all connected to one another. The abnormal retraction of the damaged colles' fascia strains the perineal membrane (to which it is connected), resulting in many of the most common symptoms. Here is a list of what important structures pass through the perineal membrane and into the space above colles' fascia and a description of what happens to them when the membrane is constricted.
Deep arteries of the penis- restricts blood flow to the penis, causing a very small flaccid and cold penis
Dorsal arteries of the penis- same as above
Dorsal nerve of the penis- loss of sensation when in constricted flaccid state
Urethra- difficulty with starting urination
Between the perineal membrane and the superficial fascia of the perineum lies the internal pudendal vessels, which supply blood to the scrotum and the penis.
The danger for us lies in the fact that prolonged contraction of these fascia resticts blood flow to the entire gential (genital) region. There are reports of testicular shrinkage and continuous penile shrinkage. When the genital and perieal area are totally relaxed, the problem is minimized, but the majority of the time , for us, the areas are far from relaxed. Symptoms are worst after ejaculation, when there is a natural explusion of blood from the area and retraction of the penis.
The blood flow problem explains why L-arginine is beneficial for reducing symptoms. The extra NO produced from the arginine relaxes the blood vessels in the region and allows more blood to get to the penis while both flaccid and erect. L-arginine has helped me a little, but it obviously won't fix any structural problems.
What we can do:
We need to stop looking at this as a penile injury and more as a lower groin injury. We need to seek out doctors that specialize in the area and can order MRIs and ultrasounds to identify fascial tears in the perineum, not just the penis. Use descriptors like chronic pain and tightness in the entire area. My guess is the exact problem is in part of the Colles' fascia near the bulb of the penis (internal base fo the penis). Regardless, an injury anywhere to this fascia will screw up the penis, scrotum, and perineum because it covers all of these areas. There is no way, I repeat no way, any of us will recover without surgical repair of the tear. I have read about one person who has had it for 12 years. Once one of us has success with this the word can be spread. In the meantime, focus on relaxing the perineal area and take supplements like arginine, this will make it a little better for you. I firmly believe normacy can be acheived through locating the problem and surgically fixing it.
Hey thanks for the info on the L-arginine. I tore the fascia where both groin muscles come through the pelvic area which has cause all kind of issues. I was also told my pelvic floor has dropped, both groin muscles are strained (permanently because of the torn fascia) and quite a few other things. Looking for any kind of relief. Been to many doctors and like many of you guys get turned away because we are challenging the doctors too much. I would love to find one person who knows more about these types of injuries.
Hi, I also have an injury similar to the discussion above, has caused for me significant shrinkage
in length (1 to 2 inches in length range, and initally girth as well) and urinary symptom of mild electric shock
feeling and extreme sensitivity to my glans (glands) (on head, making very difficult to thrust at any decent
speed during sex and hold off ejaculation). Came about after extreme scrotal swelling (at least 3X normal size) in beginning of
Sept. 2010, which I assume I caused by nicking upper scrotal sack on both sides on the underside
base at peno-scrotal junction, while trimming hairs there, next day swelling occurred and lasted
about 10 days. I used anti-fungal cream thinking it could be yeast or jock-itch, eventually swelling
subsided, was very itchy and painful, whole time penis was tightly contracted (couldnt see much shaft
from the base). Afterwards area from the base to 1 inch at least or deeper, all tissue feels very tight
and is also tight and painful to touch (but have to move sac out of the way). This tissue seems not to expand fully
decreasing my size, at first I was mortified and very puzzled. After researching "PE" (penis excercising,
enlargement, whatever your view) I tried jelquing excersice and in less then two weeks I felt the
tightness release, felt great, length & girth went back to normal size and other symptoms disappeared.
That only lasted about a week and it all retracted again, I was still jelquing for a month total and
after I stopped it retracted fully and all symptoms returned. Tried Jelquing again a month later
and had partial effect/release but not full, and length still a problem but girth since then seems more
or less Ok. Months later I used a stretching device I made that fit to the head shape near perfect to stop
head deformity while stretching long term (hours at a time), this worked great, in 10-12 days release
happened again and size was normal and syptoms (symptoms) were gone, so I stopped stretching. Only lasted a week
again and retracted again. Month later, tried device again and got same great results but had to stop
stretching due to very bad rash on penis. Once again after a week it all retracted back and symptoms
returned. Since then that device was warped (made from silicone caulking) and could not be used and
I failed at all attempts to recreate it, so I used other devices and methods to stretch with and with
very limited success in alleviating the tightness and symptoms.
Finally in Feb. of 2012 went to Uro doc
for help, he did usual checks but did nothing to investigate or treat actuall problem (he mainly a
viagra pusher), 2nd uro doc in Aug this year used scope to check for stricture (found none thankfully)
and then declared nothing more could offer me as patient, went to 3rd doc he waved white flag imm. and
reffered me to 4th doc who got me MRI; it showed nothing abnormal they say (I haven't seen it yet)
and now acting like there is no case when there definately still is. Anybody that thinks this condition is only in your
head is only thinking or saying that out of complete ignorance for the experience of the condition, it is most
definately real. I have tried massaging the tightened areas but so far this has not helped. I'm now
just beginning to try ultrasound (3 MHz) sonication to the area but cheap device we got seems very weak,
and not feeling very promising after two days. When the doc that did the cystoscopy filled my bladder with saline,
first gave me lidocaine solution by pushing it in urethra opening with syringe (sterile, no needle), the lidocaine lot
of it must have went into the bladder, when I peed out the saline I felt a distinct effect in the affected
area, like crackling of release (no noise) (or partial release, was pretty brief) I had felt several times
in the past when it all loosened (or at least partially at times). This I wonder may be effect of numbing
nerve that is affected in the area, I suspect now that it is pinched, trapped, misfiring dysfunction, causing
tissue to stay contracted, when I have released pressure from the nerve at least temporary release of tight
contraction (particularly erectile tissue in the area). If there is a fascial injury perhaps this is reason
that other muscled then re-contract causing nerve to be constricted again thus tightly contracting the
erectile tissues, and perhaps a fascial injury (maybe very slight) is too subtle to be seen/detected by MRI
or even sonography, though I would think sonography would be getting up closer scale imaging to the direct
area affected but perhaps resolution is not as good as MRI. In any event, seems like my next or even only
possible option is to try anasthetic for the nerve (like the lidocaine) or an anti-sposmadic or muscle
relaxant, but 2nd uro office declined to give me prescription for the lidocaine solution syringes (no needle),
or even where they get them nor did they recommend me to any other doctor that could help, only said they
would refer me to pain management place (which is retarded cause i dont need that, they only manage pain in
back and legs and joints anyway). If there is no chance of fascial repair (if that is the problem here)
without surgery, then if the drugs work may only be temporary fix, dont know that yet. 2nd uro doc also
gave me prescription for lidocaine (5%) patches, but they cannot penetrate to the effected tissue so they are
Anyways, I too have spent countless hours (well they are countable but i havnet counted) trying to figure this
out, and have since become much less ignorant of the underlying penile and surrounding physiology (havent
gotten any degree for that yet!) than I was before; especially since this is majorly affecting me physically
and mentally, very depressing to say the least, has put a serious strain on me and my wife's otherwise very strained
marriage already. I was for most part quite happy with my penis (size, function) before this happened
but definately not now, I sympathize strongly with anyone else affected with a similar condition. I have given up
a whole lot of faith in ever defeating it since now over two years and still in same basic condition, but I simply
not giving up , especially when definatley no where near all possibilities have been exhausted as yet to figure
it out or treat it, doctors sure give up easy because curing people or really finding causes for things is not
what their trained for and definately not what there corporate jobs are. If any one else has insight/experience
to share regarding a similar condition, I'd be glad to hear it.
Nothing has changed in my condition, but, my main "theory" if you will, is that the muscles affected are primarily the ischiocavernosus muscles (or IC) and the bulbocavernosus muscles (or BC) (there are 2 on each side left and right in the groin area behind or below ball sac). These muscles are skeletal muscles but they actually cover portions of the erectile tissue in the root or base of the penis. The IC covers what is known as the Crus of Penis (which is beginning of the corpus cavernosum chambers, top two erectile chambers made of smooth muscle that stays contracted partially when flaccid and relaxes and expands with blood when you get erect). The BC covers the corpus spongiosum (which is also smooth muscle and surrounds the urethra [pee tube]). My problem is that some porion of the smooth muscle of the erectile chambers in the base or root of my penis never basically relax or not fully and stay continually contracted, this causes some mild pain but mostly discomfort, and is the reason why I don't get to full length like before the injury. also the IC and BC muscles, I believe some of the tissue may also stay contracted continually and trigger points in the fascia somewhere near them developed also. I really don't know what is keeping it in that condition, nerve or muscle damage or both.
Hello, I would just like to bump this discussion. I am 22 years old and I have the exact same problem. Needless to say, I'm terrified and depressed. I could really use some reinforcement if anyone has any.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.