Me, myself and my penis

[LFH43]

Hello everyone!

(Drugs are mentioned, this is to give a detailed picture of my problem.
If I'm obliged to edit, I will.)

After lurking quite some time, I figured I'd join in on you guys.
Looking not only for a solution, but also sense of clarity concerning my current condition, I hope you guys might be of help.

I'm 28 years old.
Having been through some very tough and horrifying years, I'm finally gaining some perspective on a better future, after surviving a traumatic past and severe drug addiction (cocaïne).

I believe the following conditions - Diabetes type I, distorted libido and -arousal (porn, drugs) and a chronic sleeping disorder - to influence my condition.
However, I don't believe any of these to be the end all, be all.

During the fall of 2017 I suffered a penile trauma - on drugs.
Witnessing my erection dropping after a very loud popping sound, I figured it must've been a penile fracture.
However, the absence of any kind of pain and bleeding left me to figure surgery wasn't a necessary- and (considering my diabetes and state at that moment) safe option; so I just let it heal.

Some of you may know the subsequent feelings:

- Erections were never the same - my glans wouldn't fill anymore.
The only exception would be when I'd wake up after a day of doing Squats, Presses and Deadlifts in one sessions - Starting Strength training program; And if it did I'd feel pain inside my penis, while my glans would be numb.

- The severe depression and anxiety that comes with it.
Since the accident I had intercourse with different women.
My shaft would fill like normal, while my glans would only fill up to certain point, and afterwards it'd require heavy stimulation to be able to maintain my erection and ejaculate...
After some time I just gave up and started closing up - rejecting myself, this problem and women in the process...

I've seen two urologists since my accident:

- The first time shame withheld me from fully explaining the problem.
She gave me 100 mg sildenafil and a recommendation to find a physical therapist who specializes in pelvic floor relaxation - she infered that the ability to fully empty my bladder in one session and the soft glans, might be attributed to psychological problems, stress and chronic pelvic floor tension.
High- and low blood sugar levels automaticly impair alot of bodily functions, but it shouldn't be the main argument for these problems.

- The second urologists basically said, IF I did fracture my penis, it would been a minor trauma (due to abscence of pain, blood and deformity); and shoved whatever problem I'm experiencing on cardiovascular impairment due to drug abuse and diabetes, while mentioning, en passant, he can't repair anything.
He gave me 20 mg Tadalafil and told me if that didn't work, injections are the next step.

Both of them where reluctant to give a physical examation, move to medical imaging, and, in essence, give me a diagnosis.

Sildenafil (any dose) doesn't do crap, except give me a rock-hard shaft and 70%'ish filled glans, in certain angles - essentialy I have to push my shaft downward to have my penis fill up 'completely'; when I do this I can feel a very tense muscle on the connection between the frontal bone (where you penis hangs) and the upper side of my shaft.
I can also feel a somewhat strange curve.
Not only is it an uncomfortable way to get full blood flowing, the pain and numb glans also remain.

Cialis does seem to improve general sense of arousal, but gives the same effects as described above.

Having inspected my penis under cialis, I did notice a certain deformity:

The bottom-side of my penis (Spongiosum) seems to take a straight path, able to fill with blood, up until like 1 cm beneath the piece of tight skin that connects the skin and bottom-side of the glans.

Between the piece of skin and the glans, the line suddenly makes a leftward-like curve (where bloodflow and tension drop), and it's like my glans is positioned wrong onto this curvature.
If it try to bend my glans into a position in which everything alignes, the shapes just get weirder - imagine the shaft pointing north and the glans pointing north-east.
I'm unable to find any kind of stretch or mechanical manipulation to straighten this out.
All of this is visible just underneath the skin of my penis.

All of this is taking place 4 years after the trauma.
The first year I didn't touch my penis alot and it mostly hung there like a piece of dead meat - also no drugs, alcohol, but huge amounts of stress.
The second year I had sex and masturbated, both of them with the same impairments.
The last two years I became more self-concious of this problem and started closing down sexually; due to trauma healthy intimacy has always been rather hard...

I'm clean; so is my diet.
My Hba1c (blood sugar) is 6,0% (non-diabetics range: 5,7%)- shouldn't be any concern.

So, having described these symptoms, I'm hoping someone could help me out:

- Could this be a venous leak?
- Is the weird deformity related to peyronie?
- Could the ED be related to both?

The 24th I'm visiting another urologist and I'm gonna keep on pushing untill I get some imaging and clarity concerning what's going on:

- What scans do I ask?

Apart from this:

- Are injections any better compared to oral medications?
I'm uneager due to it's Peyronie effects.

- Is there any anecdotal evidence on people injecting the erection fluid into their glans or upper-part of the penis?

At this moment I'm following this daily regime:

- 200 mg CoQ10
- 1500 mg ALCAR
- 3000 mg L-Arginine
- 3000-6000 IU Vit d3
- 5 mg Cialis before bed

- Daily yoga and exercise.
- No-Fap

I'm thinking about trying prolonged fasts to see what happens, but it'll take some time and preparation (diabetes) for my body to be able to endure 48h+.

Any input, help, recommendation, etc. is appreciated!

Thank you.

[TDix]

You have a very detailed post.  I wish I could help you, but I am not a specialist.  I would be eager to see what an ultrasound shows in regards to what you mention.  Please keep us updated when that happens.  I would love to have the magic answer for you but until you are properly diagnosed I would just be guessing

[Hawk]

Welcome to the forum, and we appreciate the detailed post.

First things first, make sure you read this, paying attention to detail. https://www.peyroniesforum.net/index.php/topic,3180.0.html

Next is that it could be many things, and only an excellent urologist or a male sexual functioning doctor can diagnose you.  I suspect that you do have scar tissue near the glans that might interfere with glans erection, but that would not likely be Peyronies Disease but rather just normal scar tissue.  Scar tissue is part of all normal healing.  Peyronies Disease is scar tissue over-running undamaged tissue.

I will say that your 1st urologist sounds like she is thinking a little out of the box, and she might be of help IF you see her with full disclosure.

Can you message blood into the glans during a good erection of the shaft?

I would consider using a VED to see
1. Will it engorge the glans if you patiently hold a vacuum
2. If it does - maybe regular use would improve the situation.

[LFH43]

Thank you for the answers.

I'll give a brief update once back from the new consultation.

The first urologist is on a long-term break.
I might try and see her again if the other option(s) don't work out.

Concerning the messaging:

If I hold my erect penis downwards, blood can be messaged more easily to the glans, compared to when I leave it in whatever other position.
Holding it down also allows to push more blood into it - giving me a sensation of a bigger enlargement - which is also visible -, and more glans sensation in general.
However, the only way to hold this volume of blood, is to apply pressure on the base of the shaft, withholding the outflow of blood.
I figure an erection-ring might be of help (during sex), but it's something I'd like to discuss with the doctor first.

If VED works in a similar way, it would definitely be worth giving a try.

[NeoV]

5.7 is not a safe BG. You should be 5.0 or slightly below. Damage begins below 6.0 all throughout the body, there are good studies on this, which I had outlined in my old google document. Pre-keto, my BG was 5.7. Now it's 5.0 or lower.

Please check out The Diabetes Solution by Bernstein, The Diabetes Code by Jason Fung, and the new book this year The Case for Keto by Gary Taubes.
Keto studies and books get no news coverage, while anti-keto books and studies do get coverage despite being fewer in number and quality. It's all very sad and frustrating. This is because metformim, insulin, and statin makers are one of the biggest if not the biggest money making industries in the world, which depend on people eating carbohydrates and keeping BG higher than what has clearly been shown to be unsafe. That, and the grain and sugar industries....

Other than that, nice supplement list.

Btw, CoQ10 works probably because it lowers insulin and blood glucose, see the PCOS studies that demonstrate that.

[LFH43]

Thank your for reading, the reply's, advice and recommendations.

Yesterday I saw a new urologist and the exact cause may be determined in the upcoming weeks.
Ultrasound didn't show any abnormalities, and arterial inflow did seem regular.

He referred me to the Radiology-deparment, 8th of march, for a penile arteriography.

During the arteriography, they'll try and determine if there are any arterial- and/or venous leakages.
In case of VL, embolisation-surgery might be able to do the trick and alleviate the symptoms.

He told me if the problem is arterial (inflow), then embolisation alone won't suffice, and I'd have to look-up other treatments (oral medication, injections, VED, ointments or an implant).

So, on the sly, I'm really hoping it's just a VL.
He sounded as if VL-related problem might be fixed easily.
Yesterday, I did notice that if I place some gentle pressure on the top of my shaft, during an erection, the glans would be firmer and more sensitive, remaining in such state.
So, who knows...
Let's not run ahead of things to quick!

Concerning the BG, it really is a serious fight - this disease.
I've never managed to get below 5.2...

Currently, I'm working on counting my carbs, trying to create schemes which would allow me to dose my long-lasting insulin low enough to start fasting without hypoglycemia lurking around the corner AND to be able to practice sports without the problem.
I might go keto in the future, just have to figure out first how to safely enter the ketosis-state.

Got started in The Diabetes Solution, thank you.

Keep you all updated!

[LuisFernandez]

Bro, do not hope that it's a Venous Leak. VL surgery is useless and the only real treatment for it is an implant.
I can't tell what you have from your description, honestly sometimes keeping it simple is better. Pictures are the best.

If you have deformities that were recent, then it's Peyronie's. If you have scarring and plaques it'll affect erections in some cases. If your glans don't fully inflate it may be scarring in the corpus spongiosum (CS) or lack of arterial inflow or VL in the glans.

I take Alprostadil injections and i have found that it really helped me with my glans by breaking up scars in my CS. Also doing VED helps.

Also try using a basic silicon cock ring to help with your glans. Many men use these, even in porn.

Again, never do the VL surgery.