For the last two months I have been dealing with hard flaccid symptoms and a reduction in sensitivity. I first noticed these symptoms after a few days of increased solo sexual activity.
My urologist has been puzzled by my symptoms, and he made a tentative diagnosis of very-early-stage Peyronie's. Since then I've been doing pelvic floor physical therapy and it seems to have helped my hard flaccid and sensitivity symptoms by about 50%.
My question relates to my development of a pronounced hourglass-shaped erection that only occurs during masturbation. To be more specific, the bottom half of my penis becomes erect to normal girth, but the upper shaft does not. The glans becomes a bit bigger but not to normal size.
That said, I wake up multiple times per night with normal-looking nocturnal erections, and my erections when I'm sexually active with my wife are normal most of the time (they tend to deflate when I am anxious or when I change positions).
I was in a lot of psychological distress at the onset of my symptoms. My stress levels have gotten much better, but I am obviously still concerned and I am trying to determine whether this hourglass shape could be psychogenic or a result of pelvic floor dysfunction (as opposed to Peyronie's).
Do my normal erections while sleeping and with my wife rule out Peyronie's? Or is it possible for Peyronie's to result in a curved/hourglass appearance only some of the time?
Stress and anxiety have a LOT to do with erection quality. It can be a bad cycle as the more we think and stress about it the worse it can get.
What you are describing is not the traditional definition of hour glassing. Hour glassing is when a narrow band of your penis is not expanding fully. But I understand that your penis is expanding and the later half (towards the glans) is not expanding at the same rate. But as you get fully erect then the latter half "catches up".
People will argue if this is early Peyronies or not. The fact you still get quality erections and are able to enjoy sex is demonstrates that physically everything is working as expected.
If you are concerned about it getting worse, you might want to consider VED therapy which is discussed in detail on this forum. It is more of an exercise to pump, hold, pump, hold, etc. This would help "stretch out" this latter half of the Tunica in your penis. Think of as stretching therapy.
Don't stress about it and just be aware of any further changes.
I agree, try not to stress also, take measurements every month or so to objectively note any changes.