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Welcome to Dr. Landon Trost - Directly answering member questions in the "Medical Professionals" section below the Treatment boards. https://www.peyroniesforum.net/index.php/topic,16512.0.html

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Author Topic: Pea-size nodule under superficial dorsal vein  (Read 216 times)

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itsjustatest

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Pea-size nodule under superficial dorsal vein
« on: December 27, 2021, 09:23:35 AM »

Hello folks,

22M who will try to be concise. My sex life has always been fine until about a year ago when I started experienced Erectile Dysfunction (when having sex, when masturbating, minimal nocturnal erections). Around the same time, I started experiencing a sort of tightness on the left side of the penis, at the exact spot where it connects with the pubis. My penis began slightly tilting towards that side and the superficial dorsal vein started looking somewhat enlarged and hardened.

I went for a penile doppler ultrasound with injection from a very experienced doc. She concluded that both my endothelial and arterial functions were fine, that the deep dorsal veins were not leaking, and that there was only a small venous leak on the superficial dorsal vein (8cm/s at 10 minutes). She also saw no signs of fibrosis on the shaft.

While this sucks, it sort of supports my hypothesis that there's something going on the left part of my penis, close to where the superficial dorsal vein goes, and which prevents it from effectively shutting down. It might be motivated reasoning on my part, but this seems somewhat coherent with the fact that my venous leak is limited to the superficial dorsal vein and that other veins are not affected. From what I have read on the topic, multiple venous leaks generally occur when there's a more general problem with smooth muscle relaxation.

In fact, I have now realized that when erect, I can feel a small pea-size nodule at the base of my penis (right where it connects with my pubis), exactly under the superficial dorsal vein. I do not know how long it has been there, I can only feel it when erect, but it's definitely there. While I initially thought this might be Mondor's disease (thrombosis of the superficial dorsal vein), I got a second doppler (without injection this time) to look at the vein, and the doc concluded there was no thrombosis whatsoever. The thing is I have no F^@$!ng idea what this pea-size nodule under my superficial dorsal vein is … but it appears plausible to me that this nodule is F^@$!ng with the vein's veno-occlusive mechanism. If there's something under the vein, the vein cannot really shut off like it should.

Not only does having Erectile Dysfunction sucks, but I'm also quite freaked out by this little weird nodule… and the worst is that it's hard to get docs to do something about it since you cannot feel it at all when flaccid.

So, my questions:
  • Does my general reasoning appear plausible to you, or am I a victim of motivated reasoning (or plain stupid)?
  • What should I do next to find a solution to this (plausibly) inter-connected problem of this weird small nodule and the faulty superficial dorsal vein ?


Sorry for the long post, concision is not my main quality. Many thanks in advance for your help.
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22 y.o

Erectile dysfunction, although apparently no venous leak
Weird nodule under the superficial dorsal vein at the root of the penis, possibly remnant of Mondor's (?)
Apparently no plaques

Have a loving girlfriend who I will marry

Hawk

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Re: Pea-size nodule under superficial dorsal vein
« Reply #1 on: December 27, 2021, 11:01:50 AM »

Clearly, you have done your due diligence in seeking medical attention and thinking this through.  It has to be beyond frustrating to take all the rational steps available and get no conclusive answer.  In your case, it sounds like the doctors did not even present you with a theory or a hypothesis. As I was reading it, my own suspicion when you first mentioned the lump was that it is plaque, interfering with the vein being totally closed during the erection process. 

It appears it likely isn't plaque, but it must be more than a coincidence that you feel a lump there and you have some leakage.  The problem you are left with is what is it?  What can you or anyone do about it? And can you even be certain the lump was not there before?  A man with a healthy penis seldom palpitates it to become familiar with the feel of every structure, so we never know if what we feel even represents change.

My question would be; if all men were tested, how many would have minimal venous leak, and wouldn't a healthy young man be expected to have enough arterial blood flow to overcome some leakage?  Unfortunately, I doubt you will find clear answers to all these unknowns.  You and most doctors will find it more practical to treat the symptoms than to explore complex mechanisms associated with the exact cause.

We have the rare advantage of having Dr. Trost answering questions on our forum.  He is known widely as a foremost expert in Peyronies Disease and Xiaflex treatment and vasectomy reversals.  While he does NOT specialize in every aspect of penile health, he has sound basic knowledge of most penile issues and treatments.  In addition to his expertise, he is a rare human being who cares about others enough to serve and help where he can.  Forum rules require you to fill out your signature line and have at least four meaningful posts on the forum before posting on his board.  He will NOT directly give you medical advice or attempt to diagnose you online.  He will, however, at least give an educated response to some of the things that cause similar symptoms and acceptable treatments.

While we do not generally allow "double posting," I would post your exact post on his board as soon as you have a post count of four.

Welcome to the forum, and good luck.

Hawk
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PS: A link on signature lines -->  https://www.peyroniesforum.net/index.php/topic,10819.0.html
PS: You English is exceptional
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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

itsjustatest

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Re: Pea-size nodule under superficial dorsal vein
« Reply #2 on: December 27, 2021, 11:15:29 AM »

Thank you Hawk for your input, and your positive comments about me thinking this through and being diligent about it.

I do agree with your comments on the fact that it is plausible that some males have minimal venous leaks but do not even know about it because their dick work. And indeed, the more you inspect something, the more likely you are to find something. So it could absolutely be that the venous leak that was seen on the doppler is the top of the iceberg, that I have always had it, and that something else is causing my Erectile Dysfunction. The thing is … what ? Further, I tend to think that it would really be a major coincidence if the slight left-tilting, feeling of tightness on the left, small nodule, and weird superficial dorsal vein were not connected.

I will do as you suggest and try to get Dr. Trost's input. Nonetheless, I remain all ears to any suggestions/ideas you and others might have.

Many thanks again.
Logged
22 y.o

Erectile dysfunction, although apparently no venous leak
Weird nodule under the superficial dorsal vein at the root of the penis, possibly remnant of Mondor's (?)
Apparently no plaques

Have a loving girlfriend who I will marry
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