Urology/priapism

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QUESTION: im 26 years old I took 20 100mg tablets recreationally in about 4months, I had a few painfull prolonged erections, now my penis doesn't get hard an I can feel hardened areas and the tissue has a light yellowy tinge, i think i have scarred a lot of the tissue, it has been about 7 months i never get erections, i can have sex but my penis is soft, will this get better in time? what can be done to get the tissue back to normal, it is numb all the time will the sensation come back? do u think i should start taking Viagra everyday to try and help even though it caused this in the first place?

ANSWER: Bob:

It may get somewhat better over time, but clearly you have a problem now.  Sensation also takes months to improve.  Taking Viagra does not typically cause these problems unless you had some other issues.  For example, if the prolonged erections lasted more tha 3-4 hours, you may have sustained some permanent damage.  You should consult a local urologist.

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QUESTION: thankyou for your response, I think the Viagra caused the problem because they were giving me erections that were a bit painful at times and they didn't go down im not sure how long they lasted I didn't know the dangers of priapism at the time so I didn't know what damage I could be causing,it has been 7 months since I started to notice that my erections and sensation wasn't normal, can this definitely improve in time even though it has been 7 months already? if there has been nerve damage can they regenerate? can erectile tissue when scarred get back to normal? is there any treatment or supplements or medication I can take to help. can stem cell therapy help I am considering going to America and trying it, I have consulted a few urologist they have all said different things, I had a blood flow test done an it came back as a good blood flow in but the blood was flowing out quicker than what it should, one urologist felt the hardened area an said it was peyronies and others said it wasn't

ANSWER: Bob:

There is nothing "definite" about nerve or erection healing after an injury.  We typically wait about a year before making a final determination so 7 months is not long enough.  Oncde damage or scarring has occured to the erection bodies, it's not likely to recover completely although it may or may not make any clinical difference.  The scar tissue will remain even if the erections return to normal.  Stem cell use for this would be highly experimental and not the standard of care.  Erection rehabilitation is a new field and there is little data which is why you are getting different opinions.  If you are considering such a trip, arrange to see one of the leading experts.

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QUESTION: thanks, so is there a chance my erections will return to normal ridgidity and size? if the erections return to normal will the scar tissue eventually fade and will I lose size? what else can be done other than stem cell therapy? who is a leading expert in stem cell therapy that I should see can you give me a website or number?

Answer
Bob:

Yes, there is a chance but it is not likely to return to 100% normal if there are still problems 7 months after injury.  But it may improve to a more usable state.

The scar tissue will remain.  Your erection size will probably be much as it is now.  There is not alot that can be done at this time.  Some will recommend using viagra or cialis to help improve circulation but that could be risky as that's how you got in this mess.  Use of a vacuum system can help increase capacity but it's long term cure rate is unclear. Use of stem cell therapy at this time is still investigational and is not part of general therapy at this time in the US.  I cannot give you any specific website or number as I am not aware of any ongoing studies.  I suggest you contact the Sexual Medicine Society of North America where shoudl be able to tell you where the research is being done in the US if you insist on following this route.  

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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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