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Penis and scrotum numbness.
For the past 11/2 years my penis and scrotum feels numb.There is no sensation when i have sex even though my erection is hard.I squeege my scrotum and there is no pain but if i touch my skin slightly with a needle i feel the pain ,same with my penis.It can take me 10-30 minutes to ejaculate and the orgasm is not so pleasurable as before If i do it again within an 1 hr i have less semen and pleasure.I have been to a neuroligist and had an evoked potential test and it showed my nerves are fine,I also had an mri and had a watery cyst taken away from my perineural along the s2 to s4,but that was not the problem.My libido is low and i been taking testestorane roche tablets for 2 months because my free testestorane was low but it did not help.Sometimes i feel a slight dullness in my scrotum but no pain.I been to a uroligist and had a urodynamics test which was consistant with prostatic outflow obstruction.I had normal sensation down the urethra when passing the catheter and there was nothing to suggest a neurogenic bladder.
1.I have obstruction from the prostate or bladder neck which is long standing,semen build up in prostate,blockage from prostate.
2.I have congestive prostatities causing the subjective diminished sensation in the genital area.
No other doctor heard of this before even another uroligist.He has given me to take saw palmetto,epilobium and trionovin which did not help as i been taking it for 5 months.I don't have any symptons of prostaties.I been on propecia for 2 years and that is when i started this problem,but i been of it for 1year and i read it can damage sexual function.I'm only 50 and healthy and i'm now getting depressed over this problem,can you please help.
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233190 tn?1278553401
Tough to say without evaluation.  You have had a pretty comprehensive evaluation, making neurological causes less likely.

You can consider more systemic disorders - like diabetes or thyroid diseases.  These can be evaluated via blood tests.  

Of course, infection needs to be ruled out - this can be done with a urine sample for analysis and culture.  

Atypically, anatomical problems can lead to some of the symptoms you describe.  An ultrasound to evaluate the scrotum as well as a cystoscopy to evaluate the lower GU tract would be a comprehensive approach to evaluate these possibilities.

These options can discussed with your urologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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