Doctors clueless, I am depressed - Onset of Peyronie's?

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Pierre

Hello everybody,

I am Peter, 30, from Austria. Thank you for running this forum, it helped me a lot checking out the Survival Guide.

My situation is complicated: In my countries doctors are clueless as to what I am exactly suffering from. It makes me depressed. I am looking for help here to give me some guidance as to what condition(s) I have.

Here is the situation

November 2020: Sudden Erectile Difficulties

  • I had a fulfilling sex life until Fall 2019. High libido, always great erections.
  • Then in November 2020 I hooked up with a woman, I could get hard, but immediately lost my erection when we stopped kissing or stimulation stopped
  • I still tried to have sex with her with a "not-so-good erection", mostly did not work.
  • Went to the doctor, who gave me PDE5i. When I use this, I *CAN* maintain my erection and have sex 3-4 times a night
  • Strangely, I radically changed my diet in February, lost 5-7kg. Two weeks ago, I was able to maintain my erection and have sex 1-2 times a night even without PDE5i . However, when I tried again last week, I could not repeat this and needed PDE5i again. I should say though that I haven't been quite aroused lately.

February 2021: More Curvature of my penis, doctors are clueless

  • I always had a mild curvature to the right (about 15 degrees). In February 2021, I wake up to see that my erections look different: They are more pronounced to the right now (about 30 degrees when semi-erect, and 20-25 degrees when fully erect).
  • Also, my penis is now definitely "rotated" clockwise.
  • In total, I went to 5 (!!) doctors. Neither of them could feel palpable plaques. All of them did a doppler ultrasound in flaccid state. Results: In February, 2 of the 5 doctors spotted a small plaque near the septum, 2 millimetres in size.
  • 6 weeks later I went to the same 2 doctors. This time they were unable to spot the plaque on doppler. They tried about 10mins.
  • The doctors were somewhat clueless. I pushed them for questions, and one of them only noted that "my right Tunica in the distal portion is 0.5mm thicker than the one on the left - with no plaques detected"

I am now quite depressed...and I do have a number of questions :

  • If it is true what the doctor said about thickness of my Tunica on the right: Could this be the Onset of Peyronie's Disease?  
  • Is it possible to acquire curvature due to the above stated different thickness of the Tunica? My penis feels weird: When I flex my pelvic musles to "pump" more blood, I can feel and see that it is pumping much more blood into the left side as compared to the "thicker" right side. It then also rotates in a very strong fashion clockwise.
  • In your view, where is my Erectile Dysfunction coming from? Is it not weird that I can get equally hard with and without PDE5, but that MAINTAINING an erection is so much more easier with PDE5i than without? I thought PDE5 is only about *getting* erections...


I know these aree tons  of  questionss, but I wanted to be as structured and thorough as possible to that you could better understand my situation. I am extremely depressed and I would be grateful if you could give my case a shot.

Thank you!
30 Yrs - Single
Congenital curvature to the right (15 degrees)
Feb 2021-sudden ED w/any break in stimulation
Curve increased to 25 degrees
2 of 5 MDs w/flaccid ultrasound found small plaque but now can't
5m Cialis

LWillisjr

Pierre,
This is interesting to me. By my understanding this would not be Peyronies. But this is the first time I have considered that the Tunica could have different thickness along the length or circumference of one's penis. Sorry I can't offer any answers to you so far, but this does open the possibility of explaining similar symptoms to others.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

Hawk

Peter, Welcome to the forum.  I hope you find some useful information here.  I am sure you will find support.  I built your signature line for you to get some better input when you visit other boards on your new forum.  I knew it would be tricky to get most of it in the limited space, so I did it.

I founded this forum 16 years ago and have read most of the 130 thousand posts. I have never seen a report of one tunica being generally thicker than the other without plaque.  That could mean I missed it or I am just not informed, that it is a very rare situation, or that your doctor gave you misinformation, especially since you had ultrasounds by 5 doctors.

You mention, "I haven't been quite aroused lately." - I wonder if that is a result of depression and concern over your condition or if you could have low testosterone.  I would want a test that measures Total and FREE testosterone.  Maybe include a total hormone test for estrogen (men have it) and other hormones.

You might consider traction.  Even though this does not solidly fit the description of classic Peyronies Disease, traction would likely give some benefit to reducing the curve and preventing any increase.

Finally, keep in mind that adrenalin is a stress hormone that specifically kills erections.  Stress, worry, fear, anger all raise adrenalin.  This may be contributing to at least some of your symptoms.

Hawk
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Pierre

Hawk, Willi

Thank you for your responses. I do have a few follow-up questions:

1) My subjective feeling - which could be wrong - is that my Penis is slightly thinner when erect, perhaps 1-2millimetres. If there is less girth, wouldn't that imply that there must be some scar in the right (thicker) Tunica preventing full engorging? OR is it still possible that a thicker Tunica in itself WITHOUT a scar could lead to the loss of girth?

2) In terms of treatment, what would you suggest me to do? The doctor suggesting the different Tunica thickness suggested perhaps ESWT could help soften the tissue on the right (thicker) Tunica. (He is not doing it himself, I would have to seek another doc). Do you think ESWT could help in my case?
30 Yrs - Single
Congenital curvature to the right (15 degrees)
Feb 2021-sudden ED w/any break in stimulation
Curve increased to 25 degrees
2 of 5 MDs w/flaccid ultrasound found small plaque but now can't
5m Cialis

TDix

I definitely seek out a specialist.  A doctor that specializes in Peyronie's/men's health.  Most urologists do know about these conditions, but mainly treat prostate issues and urination issues.  They also treat both men and women.  I believe your case needs to be seen by a specialist.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

LWillisjr

Well, I am hesitant to give advice regarding symptoms I am not so familiar with.

I can see that the Tunica might be slightly thinner when erect. The Tunica stretches slightly to its limit and I can easily accept that it is thinner when fully  erect. And this might even explain how congenital curves are created from birth. You did say you had a slight curve to the right always, so this would make sense to me. I don't think this has anything to do with the recent increase in curvature, or the twist you referred to.

I think TDix is correct to suggest you get this checked out by a qualified andrologist. And I don't see any harm in doing VED or traction type therapy as I think this is just good for penile health in general.  
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

Pierre

Thank you.

Quick question: Could it be plausible that the thickened tunica is temporary? I read somewhere in this forum about a "slow-healing wound" that could lead to deformity that could be reversible.

Also I noticed that there is less of a curve the harder my erections are...but still the curvature is more than it used to be.

I am just incredibly sad...erectile issues plus the deformity I am having at this age.

Is there plaque that can be neither felt nor spotted in ultrasound? When they spotted it on ultrasound they said it was "near the septum". Could that make any difference?  
30 Yrs - Single
Congenital curvature to the right (15 degrees)
Feb 2021-sudden ED w/any break in stimulation
Curve increased to 25 degrees
2 of 5 MDs w/flaccid ultrasound found small plaque but now can't
5m Cialis