Getting an ultrasound tomorrow -- what should I expect? Does the injection hurt?

[Rags]

Hi all, sorry in advance for the long post but wanted to be as detailed as possible to explain my issue and get some input/advice.

I'm a 34-year-old male who's had symptoms of either Peyronies, "hard flaccid," or just general trauma-related Erectile Dysfunction since my early '20s... when I was 21, I had a drunken hookup in college and experienced "whiskey dick" as it's often referred to -- basically was just too drunk to get a full quality erection. When my partner tried to get on top, basically the weight of her body bent my penis in half because it wasn't fully erect. I remember it hurting and saying "ow!", but the pain was instantaneous and went away. I didn't have any discoloration or bruising etc. and didn't think twice about it the next day.

However, as the days went by, I began to notice a small "pinch" of skin forming in the middle of my penis, especially if I was sitting down (eg on the toilet) or when it was shriveled up more (eg cold weather). i'll never forget the first time i noticed it, sitting on the toilet in my dorm building, and panicking at the sight of the shriveled-up skin in the top middle of my penis. it began to get worse and took on a severe hourglass shape in the middle, almost like i had a rubber band tied around the middle of my shaft, and even now when i think back on this it triggers some really traumatic anxiety. Being 21 and embarrassed about it all, and with a lack of resources online, I had no clue what was happening and thought i had contracted an std and it was a pretty horrible thing to go through. i went to the campus doctor and didn't tell him about the hourglass shape, but said I was worried about a sexual encounter and he ran the standard std tests and i was fine, so i kinda carried on and never addressed the issue.

for years i kept it a secret out of shame/embarrassment and it did stabilize over time... at some point i discovered this forum and read about hourglassing stories and figured i had peyronies... once in a while, early on, i'd suffer random, excruciating pain in my penis that would go away within seconds. i used to work at a bookstore in college and remember one time i squatted down to put a book on a bottom shelf, and i got the most debilitating 2-3 seconds of shooting pain through my penis. this would happen occasionally. in retrospect i believe this to have been scar tissue calcifying and nerves/veins in my penis basically "forming" around it or adjusting, because i did end up getting a couple large veins that i never used to have before the injury. i'm just assuming the pain i felt had something to do with the nerves. it's also my belief that this is why my erection quality improved over time. it was almost like my body adapted to the injury to the best of its ability and formed new veins or something.

that said, i have no bend in my penis and the hourglassing is significantly better than it used to be, even when flaccid it is not as noticeable now, but i still experience it at times - especially in cold weather or if i've had a lot of caffeine (high blood pressure) - and my penis in flaccid state became longer and more "droopy" and isn't as thick as it used to be. when i am erect, i can feel the middle of the shaft has more "constriction" around it -- visibly it's impossible to really see, but i can basically feel that the blood flow is more constricted around the middle, and i do experience erection quality issues. certain positions (like my partner on top) are harder to maintain.

allllll this being said... i did go to a urologist in my late 20s and he didn't think i had peyronies and thought it was anxiety related, which it definitely is not (but the anxiety of knowing i have the issue probably makes it worse and contributes at times).  i went back to him again a couple weeks ago and showed him photos of the hourglassing and explained more about how the injury first happened and he said although he still doesn't think it's peyronies per se, he believes there's something going on and he ordered an ultrasound.

my suspicion has always been that there is scar tissue in the middle of my penis and it simply prevents me from obtaining a full-quality erection. i think when the injury first happened, the hourglassing was more severe because the tissue had been damaged and scar tissue was forming, and over time it stabilized as it calcified and those new veins formed to help deliver blood to the surrounding tissue. but, just like any injury with scar tissue, it was unable to get back to 100%. i'd say my erection quality is like 70-80% of what it used to be just in terms of ability to maintain and the feeling of fullness, and i definitely lost some girth.

he told me if this is the case, there's no treatment that would be worth pursuing as they all have side effects which would possibly make my condition worse, and he only recommends it to people who have more significant cases. but, he said just so i know once and for all what's causing it, the ultrasound will hopefully help give me peace of mind.

so i'm going in tomorrow for a scrotum and testicle ultrasound and i am looking for advice/info on what to expect. i read online that they stick a needle in your penis to prompt an erection, and i'm really squeamish about needles and kinda freaking out about this. i'm wondering how bad it really is, whether it hurts, where they stick the needle in, etc.

or, is it possible to get an ultrasound without the injection?

thanks for any input you guys might have!

[305made]

The usually don't do needles for a scrotum ultrasound just gel for the imaging. Let me know what your results are for the penis ultrasound you could try taking a ED pill before it instead of having to let them induce an erection with a needle.

[Stepone]

Rags,
There are several of us who have injured ourselves during sex, resulting with similar issues.
Sadly many of us have also had poor experiences with poorly trained urologists when it comes to penis health.
I too had an ultrasound, the injected a solution into my penis, which hurt, which gave me an erection. The nurse then used the ultrasound wand to look at the penis and surrounding tissues.
I had this done by three different urologists over a two year period and all three had different conclusions.
It's sad when I think of this, what I had to go through, but none of these doctors were very helpful. They did not have enough experience/training dealing with penis issues to really give me a good form of treatment.
I hope your doctor you are seeing is a fully trained, but from what you said, I don't think he is the best to see.
I would search for a urologist/surgeon that specializes in penis health. I would not go to a urologist that sees men and women for all sorts of urological problems as their training is too general for penis issues.
It took me a lot of google searching and phone interviews of doctors to finally find a superior physician.
An important fact/question to remember is.
What do they call a doctor who graduated at the bottom of his graduating class? Answer is a doctor.
Do you homework, find a top notch specialist who can accurately tell you what is going on and what are your options, short and long term.
I think I would still see the urologist for your appointment, but get copies of the ultrasound, etc. and search out a more qualified specialist.
Depending on where you live, check back with us and we may be able to make some recommendations.
Best of luck,
StepOne
 

[Rags]

I'm in my mid-30s now, but when I was in college I had a very drunk hookup one night around the age of 21, and during intercourse my partner tried to get on top and I remember my penis essentially bent in half under her weight -- probably because I was drunk and didn't have a good quality erection.

Didn't notice any immediate bruising, swelling, tenderness, etc., but a few days later on the top of my shaft a small pinch of skin began to form, and it was more noticeable when my penis was flaccid or in cold conditions etc. (basically anything that constricted blood flow). I began to develop an hourglass shape in the flaccid state but while erect it wasn't noticeable (thank god).

I was embarrassed and thought I had an std, went to the doctor on campus and my bloodwork came back fine, but I never really told him about the skin pinching because it was so humiliating. As time went by, the condition improved and stabilized, but it never returned to 100% normalcy. It doesn't happen anymore, but in the first couple years after the injury, sometimes certain movements -- like bending down to a kneeling position -- would randomly shoot piercing pain through my penis. In retrospect I wonder if that had something to do with new nerves/veins forming, as I did actually develop new veins that I didn't have prior to the injury over time. In flaccid state the hour glassing is not noticeable now unless I have a ton of caffeine (high blood pressure) or it's really cold etc., and even then, it's not as bad as it was the first couple years -- back then, it was always extremely noticeable to me. I would go to pee and it was like the bottom and top halves were normal but right in the middle it looked like someone had tied an invisible rubber band around my shaft and was cutting off the blood flow. It was horrible to go through.

 Now, it almost seems like my penis adapted to it and stabilized, but I also think I lost a bit of girth tbh.

However, even though its visual appearance is improved, my erection quality has suffered overall. I am fortunate that my issues aren't worse, I'm at least able to still have sex even without ED medication most of the time, but I have more trouble maintaining quality erections in certain positions (e.g. partner on top) and I almost never get morning wood anymore, and haven't since the injury. I spoke to my doctor and he ordered lab work for my testosterone and my levels are very high for my age, he said -- around 700 -- and all my other bloodwork on standard tests has been normal.

My personal theory was always that during this injury in college, scar tissue formed along the top of my penis which constricted blood flow in that area. I didn't experience the full-blown Peyronie's with severe curvature, but my assumption was that I had some level of scar tissue that was somewhat hindering things.

I finally went to a urologist who specializes in peyronies recently and he ordered an ultrasound. To my shock the ultrasound came back with no finding of plaque/scar tissue.



But I literally still get an hourglass shape at times and I can literally see the ring that runs around the middle of my penis and the pinch of skin on top where, to me, it literally looks as though there is scar tissue constricting the area.

I am now feeling quite hopeless. The urologist referred me to a specialist 2 hours away who doesn't take insurance and a consult alone would cost hundreds of dollars. He told me it could be a condition called "hard flaccid" for which not much is really known yet, but it's outside his realm of expertise and he said based on the lack of scar tissue he can not certify it as Peyronie's and it has to be something else.

Based on everything I've written do you guys have any idea what this could be that I've been dealing with for nearly a decade and a half? I'm very fortunate that I'm still able to have intercourse and the hour glassing improved over time and isn't super noticeable, none of my partners have ever said anything, but I can tell my actual erections are not the same as they once were and I can often feel like the middle of my penis (where that hour glass band forms) just feels tighter. And I think because the blood flow is reduced in this area it makes my erections far less reliable because if I don't have constant stimulation it tends to weaken pretty quickly.

Cialis helps, but I still want to get to the bottom and figure out exactly what my condition is, and it's frustrating that I can't really figure it out -- even after going to a urologist.
Is there anyone on here who might have suggestions, input, anything that would be helpful in determining my next steps before spending a fortune going to see a specialist hours away whom I'll have to pay entirely out of pocket? I'd hate to do that and then get the same lack of answers.

Thanks!

[Rags]

Hello,

Sorry for the late response.

I appreciate all your input!

I had the ultrasound done -- it was only the second penile ultrasound the male tech had ever performed and I could tell we were both equally feeling awkward about it, lol. It was kind of humiliating to have a guy rubbing a wand over my genitals for about 20 minutes but I really wanted to know once and for all if there was any scarring.

The results came back and said no scarring was found. I didn't actually receive copies of the ultrasound -- just notes from the radiologist.

My urologist referred me to a specialist in a city 2 hours away but this specialist doesn't take insurance and even just the initial consult would be hundreds of dollars.

I feel pretty defeated right now. I know what I have isn't in my head, and began after that injury almost 15 years ago in college. I was so certain for years that it was Peyronies and now I no longer know what to think, but I would love to find answers.

If I PM you, would you be willing to check out the doctor he referred me to and give your input and/or recommend someone you think might be better? Or preferably someone who takes insurance? I just don't want to spend thousands and thousands of dollars out of pocket plus drive 4 hours round trip if this guy isn't going to be the best fit.

Thanks so much!

[Andy_1492]

From my far from expert understanding I think a ultrasound is quite limited as to what can be seen. I think a doppler of the penis in the errect state gives greater indication of blood flow, vascular issues etc.

I had a similar US test, and a similarly awkward encounter with a male radiologist. When I went back to the "specialist" he just said well the scan shows nothing so you must be fine.

And I was like well I haven't had a full errection in the best part of a decade and my dick looks like something out of hellraiser, to which he said well maybe it's always looked like that.

I was like FFS give my some credit, dont you think I at least know what my own dick looks like?

[Sonic]

The thing about scar tissue is that sometimes with years it can shrink or become so small that an ultrasound doesn't detect it anymore. This could maybe be the case for you. However just because the scar tissue has shrunken or went away it doesn't mean that the deformities will go away. Sadly in many cases the deformities are permanent. It could also be that you have developed Hard Flaccid.

If you are able to have sex fine then I would not bother too much about it. Best thing you can do now is to ensure you have the highest quality erections you can daily to prevent the shrinkening effect and loss of lenght/girth. Keep taking the cialis if that helps. You can also add L-Citrulline to the mix!

[jj21]

Hey Rags,

I had the same issue. The urologist advised that even though the ultrasound may show that there is no plaque/abnormalities, that doesn't mean that it's not there. The scar tissue may be very subtle, or just isn't being picked up.

In my case, the urologist originally could feel the fibrosis, there was hourglassing, narrowing and some curvature, but the ultrasound came back with no abnormalities. It is quite common.

This doesn't mean you don't have peyronies. Some people even call what you have pre-peyronies, where the plaque may have not yet calcified, but most likely will in the future.

I recommend you talk to your doc about pentoxyfilline, cialis daily and starting VED. This combination really helped me in the early days.

Best of luck.
J

[Rags]

The thing about scar tissue is that sometimes with years it can shrink or become so small that an ultrasound doesn't detect it anymore. This could maybe be the case for you. However just because the scar tissue has shrunken or went away it doesn't mean that the deformities will go away. Sadly in many cases the deformities are permanent. It could also be that you have developed Hard Flaccid.

If you are able to have sex fine then I would not bother too much about it. Best thing you can do now is to ensure you have the highest quality erections you can daily to prevent the shrinkening effect and loss of lenght/girth. Keep taking the cialis if that helps. You can also add L-Citrulline to the mix!

I can have sex fine for the most part (and without any issues if I take Cialis)... off medication, occasionally I run into issues with certain positions, or if I'm tired/anxious etc.... basically anything that might impact someone who doesn't have a condition like this to begin with, but it's just more magnified for me. I feel like sometimes in those situations my erection will be about 95% of the way there, which is fine in certain positions but if my partner tries to get on top etc. then not so much.

What concerns me most of all is that I pretty much never have morning wood anymore, and haven't for years. Pretty sure it began around the time of the hour glassing in my early 20s but not sure. I just can't really remember the last time I woke up consistently with erections. Normally if it happens lately it's because I have to urinate. I don't know if that's a serious problem or what it indicates but I just feel like something isn't right, obviously, and wish I had some answers on what's causing it.

I do think my symptoms sound like they could be Hard Flaccid. Just my luck that my urologist told me he knows next to nothing about this condition and that's why he referred me to an expensive specialist 2 hours away who doesn't take insurance, lol. I just feel like I can't win with this thing.

[Rags]

This doesn't mean you don't have peyronies. Some people even call what you have pre-peyronies, where the plaque may have not yet calcified, but most likely will in the future.

So this injury, if that's indeed what caused it (and the hourglassing started days afterward so I feel like it must have), occurred when I was 21 and I'm almost 35 now.

Initially, it was much worse than it is now. The hourglassing was constant, very constricted and narrow looking around the center, and always looked droopy. I basically gained length in flaccid state but lost girth.

My gut instinct has always been that it actually stabilized/improved over time, because I had some new veins gradually form along my shaft, and the hour glassing got better. I used to occasionally get shooting, stabbing pains for a split second and I think it was either plaque calcifying or veins forming and some sort of nerve related thing.

I guess what I'm getting at is that I think I may have had the pre-peyronies back then when it first started and now it has stabilized enough to the point where my condition is markedly improved, either due to the plaque minimizing/healing somewhat or new veins forming, but seems to have hit a ceiling for recovery. I'm fortunate it's not worse, and that it isn't as bad as it was the first few years after my injury, but there are definitely times where the hour glassing is noticeable even now, and I still have those occasional erection quality issues / lack of morning wood. But I haven't noticed it get worse whatsoever, so fingers crossed I've reached the point where it at least stays the way it is and never reverts backwards to how it was early on haha.

I recommend you talk to your doc about pentoxyfilline, cialis daily and starting VED. This combination really helped me in the early days.

I did just recently get a daily 2.5mg Cialis prescription but my urologist said I could also just take it "as needed" if I wanted to, and that's how I've been using it lately.

Is there a benefit to daily usage? I get worried about relying on the medication and I guess I'm worried I could build a tolerance or come to need it / worsen my condition, since currently I'm usually able to perform sexually at least to some degree. There have been times my erection has weakened in certain positions but overall the Cialis is more of an insurance policy (especially with new partners) so I know for sure I won't have any issues.

That being said, do you think I'd benefit or see some long term recovery if I begin taking it daily? Can you tell me a little more about pentoxyfilline? My urologist didn't mention that one, but I can try asking about it next time I'm there.

[jj21]

Cialis: there's a study somewhere that indicates daily usage can prevent or reverse fibrosis (it's been a while since I read it). Will also help with blood flow, getting oxygen into the tissue and promote healing.

Pentox: there's studies and a few people who had benefit from it. It's a very strong anti-inflammatory and also can help reverse fibrosis I believe. It's usually the first medication urologists prescribe for peyronies.

Your condition seems stable, improving. This is good, many of us get worse over time and the conditions just progresses... I suggest light VED, pentox and cialis and you should be able to improve. The 3 cylinder VED is good for hourglassing, have a look at the protocols on this forum and always use with caution.

J  

[Rags]

Cialis: there's a study somewhere that indicates daily usage can prevent or reverse fibrosis (it's been a while since I read it). Will also help with blood flow, getting oxygen into the tissue and promote healing.

Pentox: there's studies and a few people who had benefit from it. It's a very strong anti-inflammatory and also can help reverse fibrosis I believe. It's usually the first medication urologists prescribe for peyronies.

Your condition seems stable, improving. This is good, many of us get worse over time and the conditions just progresses... I suggest light VED, pentox and cialis and you should be able to improve. The 3 cylinder VED is good for hourglassing, have a look at the protocols on this forum and always use with caution.

J

Thanks a bunch, really appreciate it!

[Rags]

Thanks.

I may just end up biting the bullet so to speak and scheduling with the specialist a couple hours away and paying out of pocket. He may recommend more comprehensive testing that would be covered by my insurance at an outpatient center rather than from his office.

[Rags]

Cialis: there's a study somewhere that indicates daily usage can prevent or reverse fibrosis (it's been a while since I read it). Will also help with blood flow, getting oxygen into the tissue and promote healing.

Pentox: there's studies and a few people who had benefit from it. It's a very strong anti-inflammatory and also can help reverse fibrosis I believe. It's usually the first medication urologists prescribe for peyronies.

Your condition seems stable, improving. This is good, many of us get worse over time and the conditions just progresses... I suggest light VED, pentox and cialis and you should be able to improve. The 3 cylinder VED is good for hourglassing, have a look at the protocols on this forum and always use with caution.

J

actually, one more question, sorry...

my urologist referred me to the specialist I mentioned, and so I'm still going to ask my original urologist about the Pentox and a traction device, but if he says it's out of his ballpark and he can't prescribe anything else and tells me once again to refer to the specialist for further input, I was wondering if there's a specific traction device you use / recommend that I could possibly just pay out of pocket for online...? Because I may need to wait until next year to see the specialist so that I can at least count it towards my out of pocket deductible for insurance. He has a waitlist anyway so it'll probably be a while before I can get in to see him regardless.

[jj21]

I was wondering if there's a specific traction device you use / recommend that I could possibly just pay out of pocket for online...?

Some people on this forum (check the traction section) have found success with Restorex and Penimaster Pro. Use at your own risk though, there are people out there who ended up worse. Restorex you can use for 1 hour a day, 2 x 30m sessions, and you can bend against the curve. Penimaster Pro is more of an all day device, straight traction only. You should be able to purchase either online.

Google 'restorex peyronies studies' and you will find them. Neo has some videos regarding penimaster (you'll find him on this forum somewhere and on youtube).

I think the 3 cylinder VED is more beneficial for hourglassing though.

J

[Rags]

Thanks a lot.