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Primary impotence followed by substance abuse

I'm 28 years old and have never been able to have sex in my life, despite having had more than enough opportunity with more than attractive, willing partners.

I used to have decent erections as a kid, but I discovered masturbation at 13 when prone, rubbing (rather vigorously) into a bed. This may have led to Traumatic Masturbatory Syndrome at a young age. I am uncircumcised.

A few years later, when I discovered regular hand masturbation, it was so much more convenient that I did it all the time. It became like a stress buster for me and I was at it 3-4 times a day on average. I remember days when I masturbated as many as 13-14 times, maybe even more. I even masturbated by rubbing my penis through my jeans.

I preferred to stand on my toes and always clenched my pelvic muscles since that helped a quick orgasm. I soon needed more and more work getting to orgasm and eventually more work getting it up. By the time I was with a woman for the first time, I'd lost the ability to have an erection unless I was alone and used my hand. As soon my hand stopped, the erection died.

I left it untreated for many years, partly because of embarrassment and partly because I thought it was a simple problem that would take care of itself eventually. (Yes, I know.)

I have, in that time, been a heavy smoker and a Type-A alcoholic for 10 years. I was an active footballer and swimmer, but have now lost a lot of muscle and stamina. I've become relatively skinny and weak. I’ve kicked the masturbation habit, since I've now read about its harmful effects. I've quit smoking and drinking completely.

Today, I have trouble getting any kind of erections. Even the weak ones need increasingly vigorous hand movement, and last only seconds after it is stopped. I have tried sildenafil and tadalafil, with decent results: I have great hard ons, but they still need my hand to remind them how to feel. I have no sensation in my perinium, possibly due to many years of riding a bike. I don't get morning wood, haven't in years.

I also have had phimosis for as long as I can remember, and a tight frenulum, for which I was recommended a frenulectomy. I got that about 6 months ago. The doctor has now recommended a prepucioplasty to ease up the tight foreskin. I’ve tried stretching exercises for a year and that hasn’t got me anywhere.

I have trouble urinating, with all the symptoms of prostate inflammation. The few times I do allow my self to masturbate, the ejaculate is minimal and almost clear in color. I still need to clench my butt to keep the erection, even for a short time.

That's about as much as I can say right now. Is there any hope for me at all?

- Andy.
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