New here! Questions on diagnosis and pain

[johnny_nap]

Hello!

This is a great forum, thanks for running it!

Here's my situation: Had a lot of sex back in December 2020 and must have incurred an injury. in January I developed a 20 degree curve to the left - it has stayed that way until today. It's a curve with no indent, the length of my penis has definitely stayed the same. Not so sured about girth (never measured it before).

Diagnosis: I went to a total of four urologists/andrologists who seem to have some solid knowledge about Peyronies Disease. They all did (a) palpation and (b) flaccid ultrasound. None of them found plaques on palpation and ultrasound. The first exam was in February, the last one, inlcuding ultrasound, was this Monday. In between, the other two palpation/ultrasounds took place.

Weird: When I touch my dick, I sometimes feel the left corpus slightly harder. But when I keep on touching for a few seconds or just pull back my foreskin, it feels equaly soft along the shaft on both sides.  

Pain: I do NOT have pain in my shaft, either erect or flaccid. However, I have a kind of weird pattern of pain: When I sometimes have intensive/vigorous sex (i.e., 3-4 times a night), the tip of my glans (and the area 2mm left and right from it) would hurt for 3 days, i.e. the urethra , both flaccid or erect (erect it hurts a bit less). It's not a strong pain, but a little bit of discomfort. After that period, the pain would subside. When I press my glans quite hard, there is not pain though...it's kind of a slight, burning, itchy sensation mostly when flaccid.

At this time, I am thinking of a strategy to deal with this. I still have several questions, the following are most pressing though :

• Is there a possibility that - though being a new deformity - I might not have Peyronies Disease?
• I am concerned with pain as it is a typical Peyronies Disease symptom. Are my pain symptoms typical of Peyronies Disease?
• Is it reasonable to assume that plaque should be visible on ultrasound approx. 6 months after a defomity is observed?  

Obviously, I am expecting not concluding answers to all my questions, but I would be super happy to get some input based on your experience. I will of course pay visit to more (experiences) doctors.

Thank you!  

[Benraycamp0]

Hi johnny_nap!

Welcome to the forum!

Please read through our Survival Guide as it has a ton of useful information about this condition -  https://www.peyroniesforum.net/index.php?topic=3180.0

Could you please take a minute to fill out your signature line? It's hard to remember your case details out of 20,000 members. You can find instructions here - https://www.peyroniesforum.net/index.php/topic,10819.0.html

Interesting case! How old are you?

[Mikel7]

Welcome Johhny_nap to the forum! I  would say that the vigorous sex could be irritating your urethra.  Have you ever had a UTI? You may just have a slow healing wound with no plaque forming. How are you NTE and erections in general? How is your general health? You could try some of the items listed in the survival guide but watching and waiting should be employed here. You could even try some light traction out.  You should be gentle with your penis and slow things down for healing - it is not a jackhammer.    Mikel7

[johnny_nap]

Thank you, Mikel7.

I am generally in decent health, I am a semi-professional swimmer and thus my weight and fitness are quite ideal.

NTE/morning erections: I do get them and notice them on average every other night - I either notice when I wake up in the morning or sometimes I wake up in the middle of the night with an erection. However : I notice that in the morning two things: First, my morning erection is not at 100%, i.e., rather at about 80%. Plus, sometimes I wake up with a blood filled penis, i.e. as if I had an erection shortly. Second, on my way to the bathroom my dick erection deflates slowly. That was different when I was in my teens.

Otherwise, erections are ok.

I will also follow the UTI route. I also noticed some pain around the urethra when peeing, though not alway.

Regarding a "slow healing wound". How long would it take for something like this to heal?  

[Benraycamp0]

Hey! Thanks for filling out your signature line.

Given your age, symptoms, and the fact that your urologists couldn't palpate any scar tissue - this could just be some injury causing a minor deformity. Some top Peyronies Disease docs would be hesitant to give the Peyronie's Disease diagnosis to someone like you. Dr. Levine will call it a "slow healing wound". In his mind, if he can't palpate scar tissue and there is minor deformity, it could be something other than Peyronie's Disease. Your age makes that all the more likely. On the other hand, some doctors will say that any acquired deformity of the penis means Peyronie's Disease (if no other obvious differential diagnosis is apparent). In their minds, they see a new deformity and conclude Peyronie's Disease since that's really the only thing we conclusively know that can cause deformity.

At the end of the day, I've come to realize it doesn't matter! As men going through this condition with similar symptoms (minor deformity and no pain), we are mainly concerned whether it's going to get worse. Sure, it'd be nice for this new deformity to completely go away but just knowing it wouldn't worsen would be pretty relieving. Unfortunately, once again, nobody knows or can predict that!

Now we're stuck with accepting that we don't have a 100% diagnosis of Peyronie's Disease and on top of that, there's no way to know to know for sure if it will get worse.

So you do as the top Peyronies Disease doctors do and realize that you can only focus on your symptoms presenting today. You are young (relative to the typical age of Peyronies Disease patients), have a 20 degree curve to the left, no palpable scar tissue, and no pain (apart from the glans/urethra pain post vigorous sex). We know for a fact that your current symptoms do not stop you from continuing to have a great sex life (in fact, I'm sure in some positions your girl really loves her new curve 😉).

Given your case, the only treatments you should really consider are traction (Penimaster Pro or RestoreX) and the supplements listed in the Survival Guide. The prescribed oral therapies are up to you (I'm sure you'll find a doctor to prescribe them), but they aren't really necessary given your symptoms.

What's the goal of these treatments? To correct the current deformity and prevent worsening (IF it actually is Peyronie's Disease). However, you may also elect to not do the treatments at all and just observe as you have been for the past 7 months and it may remain like that or improve on its own over time. How long would that "improve on its own" take? Could be months or years according to Dr. Levine.

The good news is that your case is really mild and all current symptoms points away from the worst case scenarios that some may experience. You're also very likely to find success with traction (making that current curve lessen significantly).

Hope that helps and doesn't confuse things even more haha! Trust me, I know what you are going through since I've been there myself. In fact our timelines are quite similar  

[johnny_nap]

Thanks, Benray. This is a very good and plausible answer.

I hope that it does not worsen (and perhaps improve) so that it may be just a slow healing wound.

One question: when palpating my flaccid penis myself I feel that both sides are soft and elastic. However, the left side (where the bend is) sometimes feels slightly less elastic as compared to the one on the right. Sometimes when I press, a hard area or thicker line would form on the left side, but after a few seconds, it gets soft - in fact oftentimes as soft as the right side.

Doctors could not confirm this observation of palpation. Only one of them said that "the left side may be a little more prominent". That was in February.

Is it possible that this could be scar tissue forming?

[Benraycamp0]

I hope so too!

As far as feeling a harder left side, it does sound strange how it fluctuates in hardness. Palpable scar tissue shouldn't change from hard to soft. The way you are describing it almost sounds like more of a Hard Flaccid issue (except you don't seem to have the majority of the other symptoms and it's only prevalent on one side).

It makes sense that, due to the new curve, there is some scar tissue in your left side causing a lateral curvature. Again, this doesn't necessary mean Peyronie's Disease. Since your urologists are struggling to feel it, it's probably very small and could be deeper in the tissue.

Regardless, it really doesn't matter at the end of the day. The best thing to do is jump on the supplements and traction (if you'd like, but not necessary). It's been 7 months already with no changes which is already a really good sign so it is significantly more likely to remain/improve than it is to worsen.

[Mikel7]

There very possibly could be some scar tissue on that side.  In my case I had a very similar case with my glans feeling pain at the tip.  The Dr said the ultrasound showed some scar tissue forming but found no plaques and that it could be a slow healing wound.  Later on about 4 months down the road I had a dorsal curve form.

[johnny_nap]

Thanks, Mikel7.

Did your glans pain also subside a few days after sex - or has the tip of your glans been painful always, i.e. independent of sex?

Regarding the scar tissue, how did yours feel when you visited the doctor? Was it also super soft at times, but sometimes also slightly harder? Or could you feel the typical bump/lump? What was it like, if you could elaborate a bit that would be great.

Can I also ask what you mean by scar tissue on US that is not plaque?

[Mikel7]

There was pain after sex for about 1 1/2 days and it was localized at the tip.  The Doppler only showed some inflammation at the glans and that there was scar tissue surrounding the tip areas.  Dr Levine said this could be from an injury thus a slow healing wound or peyronies - it was difficult to say. When it all started I could feel a very small lump surrounding the inner portion of my glans that was slightly painful. I don't recall being injured during sex - but for me sex has usually been quite robust and I could of injured the tip without knowing it.

[johnny_nap]

Thanks for the information, Mikel7.

I did not know that scar tissue can form in the glans/CS, I thought it would only occur in the CC?

My glans pain at the tip comes sometimes after sex and goes away after a few days. Doppler in flaccid state did not detect any scar tissue. Did Dr. Levine in your case spot the scar tissue in the flaccid or erect ultrasound (or in both states)?

[Mikel7]

Did Dr. Levine in your case spot the scar tissue in the flaccid or erect ultrasound (or in both states)?

He spotted it in the erect ultrasound.

[johnny_nap]

So he missed it in the flaccid ultrasound? Did he by any chance say that it's hard to spot plaque in the glans when performing flaccid rather than erect US?

You are saying you had a dorsal curve later on. Is this the result of the scar in you glans? Again, I thought plaque only develops in the CC...

[Hawk]

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Best Wishes!