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Urology/Penis was bent and now trouble with erection

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QUESTION: Dr Leslie,

For background I am a generally healthy male, mid-twenties. This morning I woke with an erection and rolled over to the right onto it with my hand pressing it down so that I came down on it in a position of around 4-5 o'clock viewed from above. I felt a short sharp pain down past the base of the shaft on the right side (and maybe a tearing feeling, but this might just an interpretation after the fact). I didn't think a huge amount of it at the time, although I suppose I lost the erection quickly. However later in the day I noticed that I had not gotten anything like an erection all day. This evening I attempted to achieve an erection, but I am not getting any response. Manual stimulation feels good, and I feel the normal signs, heart quickening etc., but literally have no progress toward erection. Beyond this and maybe a little discomfort in the area (I am not totally sure what if I am just imagining this though), there are no other symptoms. I am not experiencing any visible bruising, blood in urine, or strong pain.

I have done basic searching on penile fracture, but it seems like there would be more obvious symptoms.

I am wondering if this is something I need to rush to a doctor about or whether I should give it a few days and see if there is any progress.

Thank you for taking a look.

ANSWER: Dean:

I can't determine the degree of any injury from here, of course.  And you are correct that a true penile fracture usually is associated with very significant pain, bruising and swelling which you didn't notice.  I suggest you contact a local urologist and get checked.  It's quite possible that you may only need some temporary help such as viagra or similar medications.

---------- FOLLOW-UP ----------

QUESTION: Thanks again for taking a look, I really appreciate your uncompensated efforts here.

I met with a primary care physician this morning, and he said everything appeared normal from a surface investigation and urine sample saying that it was "probably psychological" and told me to wait a week or so, but it definitely feels wrong to me. I literally feel as if I am not retaining any blood there. He said he didn't know of any other tests to do and didn't offer to refer me when I asked.

Have you ever heard of anything similar to what I've described (is it possible to tear the tunica albuginea without a bloody mess?)? Is it likely that waiting for a period of time as suggested would cause anything irreversible?

Answer
Dean:

There are several questions about similar problems here on this forum.  If your primary care can't help you, won't offer some help with viagra and won't refer you, you may want to contact a urologist directly.  I have never seen or heard of an actual tear of the tunica without very significant symptoms, pain and swelling; but in medicine almost anything is possible.

Since we don't know for sure what may have been injured, I can't guarantee to your that it will necessarily heal without problems although that is the most likely course.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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