Update on My Condition

[Kickit40]

Hello Gentlemen,

I wanted to provide an update on my condition and where I am at with my treatment.

Here is a summary of what my issues are and what I have done:
Toward the end of 2018 I was having some Erectile Dysfunction issues but didn't think that much about because there was a lot of stress going on at work and it wasn't just happening.

I had a vasectomy the early part of January in 2019.  About three days after the vasectomy I injured my penis stepping into a truck (sounds stupid and unsure how I hurt it).  The injury resulted in a bruise down the left side of my shaft and into the high groin area.  Urologist and he said everything should be fine but I had small hematoma where my penis meets my groin.  Fast forward a few weeks my entire penis started to feel hard whenever I was flaccid and was a little smaller than normal.  I went back to the urologist and he said this is something he hasn't seen before.

I went to see the second urologist and he thought I had high flow priapism.  He thought it would heal itself but said I could get an arteriogram to see if there was a fistula.  I got the arteriogram which showed nothing.  Went back to the urologist and he recommended I see someone else.

The 3rd urologist said this isn't something he has seen before but thought it would pass.  I told him I can get about 75% erections sometimes but that's when I am fully aroused. He Rx Pentox and daily Cialis with the hopes the body would cure itself and he tested my testosterone which was 320.  I went back to him a few more times without much improvement and he recommended another urologist to me.  He thought I had a form of Peyriones but my penis doesn't have any curves, hasn't changed in size, and the harden spots are on both sides of my shaft running up and down the penis.

In searching for help I came across a medical clinic that uses a tool similar to Gainswave called Big D Wave.  I have gone through six sessions of the Big D Wave along with getting a P-Shot.  I also have being doing VED for about a month. They also tested my testosterone and it was 280.  I recently got on pellets a week ago to boost my testosterone to see if that will help.

Every specialist I talked states they have never seen anything like this before.  My penis looks the same size flaccid or erect, maybe even slightly biggest because of VED, but along the entire shaft on both sides it feels hard (no curve).  I can press into the penis with no or very little discomfort and when I pee the penis feels close to normal. I will even take a 20mg dose of Cialis and my erections are still not consistent.

Daily Medications/Supplements:
Cialis 7.5mg
L-Arginine
Nattokinase (very recently started)
CoQ10 (very recently started)
Pentox

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Update:

After being on testosterone pellets for a month my levels were around 1000 so it looks like my Low T issue has be resolved as I am horny damn near all the time.

I also recently got a doppler/ultrasound and the results are below:

EXAM: US DOPPLER PENILE
HISTORY: Male with possible Peyronie's disease, referred for ultrasound to assess for plaque.
TECHNIQUE: Survey ultrasound imaging of the penis was performed utilizing dorsal, ventral, and coronal scanning planes, including limited duplex Doppler, with representative images obtained.

FINDINGS:
Statements: None.

Soft Tissue: Ultrasound evaluation of the soft tissues of the penis reveals no focal calcifications or other abnormality. Limited duplex Doppler evaluation reveals normal waveforms within the right and left cavernosal arteries.

IMPRESSION:
1. Normal sonogram of the penis, with no discrete calcified plaque or other abnormality identified by sonography.

It doesn't look like I have scar tissue or Peyrione's based upon the doppler/ultrasound.   My penis size is same flaccid or hard previous to all of this happening.  I still have what I would describe as hard flaccid.  Up and down both sides of my shaft feels constantly hard or constricted.  I still have some ED even with Cialis.  

I am not sure what the next steps or even if their are next steps.  What is interested is when I take Aleve my penis will actually become less hard flaccid and more normal soft flaccid.  I am wondering if there is inflammation in penis which is causing this.

Any thoughts or opinions welcomed.

[Hawk]

Was your Doppler performed with ot without an erection to assess blood flow?

In answer to your next steps or whether there are any, there are always additional steps that can be taken if you are not getting satisfactory erections.  

Hard Flaccid - I founded this form 15 years ago.  My personal history and forum experience are extensive.  I have to admit however never having a grasp on the term "hard flaccid".  I am not disregarding the term since many men use it.  It just does not register with me.  If you have no plaque then I suspect (as I always have suspected) that hard flaccid simply means that your penis is contracted and condensed much like your scrotum will tighten up at times when cold or aroused.   I have doubts that it indicates any disease or condition and might be more a result of stress and an absence of relaxed sexual arousal.

I would say that your most pressing solution is to get the blood circulating in your penis.  That can be accomplished with a combination of any or all of the following:
VED, daily Viagra or Cialis, moderate heat (Water, infrared, hand warmers), 1/2 of a 50 mg Trazodone with a snack at bedtime, L-Arginine or L-Citrulline

Blood flow is rehabilitative and restores and maintains penile health.  That is why a healthy male gets nighttime erections (NTE's) from infancy to old age.  Circulation helps combat Erectile Dysfunction and it helps prevent plaque and loss of size.

I would avoid masturbation just to increase spontaneous erections day and night.  
PS: Just mouse over any underlined terms for a pop-up definition.

[program4004]

Right now I'd monitor everything. Don't masturbate or have sex until you are fully aroused. But it's a good thing the ultrasound was unremarkable. Like really good. Also no curvature too that's also a good sign. If you aren't active or anything I'd recommend some cardio and see if that helps your situation further since you'll get better circulation. I remember when I'd workout I'd workout like 3 weeks at a time and then rest a week and start again. This helped my libido return and I'd get my strongest erections.  

[Kickit40]

Thanks for the responses Hawk and program.

They did the ultrasound in a flaccid state.  

I am currently daily daily Cialis @ 7.5mg and using VED twice a day for 10 minutes to help with blood flow to the penis.  I am highly active as I am working out about 4-5 times per week.  

I am wondering to if this is due to stress.  I know everybody holds their stress in a different place but would find it weird in the penis/groin area.  Is there anyway to check for this?

[kusher]

flaccid ultrasound is completely useless. when u engage in sex, it is with ur erect penis not flaccid. abnormalities and deformities manifest themselves during erect state. u gotta do ultrasound with injection to check the functionality of the penis and inflow and outflow, rigidity etc...    these what matter during sex.

[Hawk]

Flaccid ultrasound is not "COMPLETELY" useless.  It would very likely pick up plaque and certainly pick up calcified plaque.  It would not, however, show blood flow patterns.

Also, it is not a matter of holding or concentrating stress in your penis.  Stress produces adrenalin just as fight or flight syndrome does.  Adrenalin kills erections because it attaches to the receptors that Nitric Oxide attaches to in order to relax blood vessels for an erection.  This is in addition to the fact that if you are worrying about your penis then your brain cannot mentally fully focus on sex.  

[samsung]

I just got an erect ultrasound from Dr. Eid and he told me "you cannot tell if a plaque is calcified from an ultrasound. You need an x-ray." Let the debate ensue...

[Hawk]

No debate.  He personally does ultrasounds and reads them several times a week.  You cant tell is a plaque is calcified with ultrasound, it takes an x-ray

[samsung]

Good to know. That also means my previous uro is an idiot because he told me my plaques were "moderately calcified." He also told me I had venous leakage. Dr. Eid said I had zero venous leakage. My trip to Dr. Eid was time well spent. I still might have calcified plaques, but I kinda don't want to know because it won't change anything. I also don't think most people here really know whether they are calcified or not. The term gets tossed around alot but I bet a billion dollars people aren't getting dopplers AND xrays and I bet they don't really know whether the plaque is calcified or not.

[Kickit40]

Hawk - thanks for the information and your opinions on hard flaccid.

I am very relieved to hear I do not have any plaque at all which is a major win for me.  

To recenter the conversation, are their possible next steps for me?  Has anybody gotten a pelvic ultrasound or CT scan to help further diagnosis?

[Hawk]

I also don't think most people here really know whether they are calcified or not. The term gets tossed around alot but I bet a billion dollars people aren't getting dopplers AND xrays and I bet they don't really know whether the plaque is calcified or not.

I  tend to agree with your assessment that you expressed in that quote Samsung.

I am glad the visit was of value to you.  I am kind of interested in how you got along with Dr. Eid and your impressions of him as a Dr. and just as a person.  Also, did he discuss the possible pros and cons of an implant in your case?

PS: maybe reply in another topic so we do not walk on Kickit.

[Hawk]

If you are primarily having ED issues the next steps to for you should be assuring bloodflow.  I can not recommend anything that would be better than what I recommended to you in my last post about blood flow.  That IS the goal.  Please re-read that post.

[Kickit40]

Thanks Hawk.

It would be great to hear from others who have had hard flaccid. I am curious what they did to overcome and if they had ED as well.

Thanks in advance.  

[Kickit40]

I still have been on the board researching to see if I can get help on my condition but I wanted to provide the latest information.

I have been going to pelvic floor therapy for almost six months now, VED a few times a week, and masturbate about once a day or sometimes more

My penis is starting to feel better and will feel completely normal flaccid except for the last quarter of my penis feels hard/tight.  I will get some tightness at the root while flaccid from time to time.  Whenever I get an erection I now have about a 30 degree downward angle because the last 25% doesn't fill all the way and always feels really limp.  If I flex my pelvic floor it does become straighter.  

I went to the urologist last week and he thought I had a fracture that was healing but we are going to do another ultrasound/doppler later this week.

I am wondering if it's an arousal issue or if my penis is still healing or pelvic floor issue.

I welcome any thoughts.

Thanks in advance.  

[shrunken_dick]

@kickit40 ; glad for you brother. Did you notice any increase in your size because of VD?  

[Kickit40]

My size (length & girth) is back to where it was prior to the injury, flaccid and hard.  

Where I may lose some size is because of the 30 degree downward curve.