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Urology/additional treatments for nerve injury

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QUESTION: I am in the process of recovering from an unexpected rough sex injury 4.5 weeks agoÖ My penis endured 2-3 minutes of vigorous frottage with lube, but also my partnerís full body weight, or thatís what it felt like. Since then, Iíve had numbness and pain at the root of my penis, occasional hard flaccid episodes, tingling all along the shaft, and dramatically weakened erection strength and frequency. Things seem like theyíre getting better generally ó for example, lately Iíve had a lot more tingling, and less numbness ó but still Iím quite frightened.

Iíve seen a GP and a urologist who both said all will be well, and they were heartened by the lack of any visible swelling or bruising. At this point I am also getting good emotional support. Still, any additional assurance that injuries like this can and do get better would be much appreciated! (I know nerve regeneration can take months.)

Also, in the days and weeks ahead, would the following be helpful/harmful?

- Warm compresses / baths
- Anti-inflammatories
- Gentle touch to ďreteachĒ skin different sensations
- Masturbation, with gentle touch + lube (on the theory that erections or partial erections will drive more blood to the area)
- Viagra or Cialis for the same reason
- Cultivation of sexual fantasies to keep those "brain maps" working
- Avoidance of all masturbation

ANSWER: Eddie:

Many of your suggestions seem reasonable, but there is virtually no data or studies to indicate which might actually help.  Taking cialis and avoiding additional injury at this point would seem to be the most reasonable.  Check with your local physicians to see if they recommend anything else.

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

QUESTION: Thank you so much for your help!

A quick follow-up question... One mysterious symptom I've had since the injury is that the first roughly 1/2 of my penis closest to the body gets erect at a normal rate in response to stimulation, but then the second 1/2 including the glans stays "floppy" for a long time. It eventually gets hard but there's a considerable delay. It's a very noticeable effect... almost like a line dividing my penis. I think it might be healing slowly, with more of my penis joining the "normal" side as the weeks go by but I can't quite tell yet if that's real or not.

Any thought on what medically might be going on here? I assume this is related to nerve injury like my other symptoms and therefore just needs a lot of time and positive thinking, but wanted to 2x-check. I have my next urologist appointment already set up, but unfortunately they can't see me for another 10 days. (I can try to accelerate that though if you think this issue needs more immediate evaluation/treatment.)  I wasn't fully aware of this symptom in earlier weeks b/c it was masked my other things going on, but now it's fairly obvious.

Best wishes, and happy new year.

Answer
Eddie:

I can't explain your finding that half the penis stays flaccid.  This might occur if scar tissue is interfering with the erection process.  The entire interior of the erection bodies are connected so it can't be from lack of blood flow.  See what your urologist says.

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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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