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Urology/8 months later - still pain from jelqing

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Question
Hey Dr Leslie,

I'm a 23 year old who desperately desires to increase his penis size. I started with jelqing only, but I was overzealous in the number of repetitions I did each session. Things went fine at first but in late August/early September of 2012 I noticed some very sharp pains on the left side of my penis, occuring in what felt very much like a thin 'tube' (vein? artery? felt like bulbocavernous artery on left side, according a detailed diagram). It was pulsating and sharp, running down the underside left side of the shaft. Obviously, I stopped jelqing. What I figured would be a max three week layoff has turned into almost 8 months without much improvement.

My symptoms at this point are odd. Luckily, I can still get raging erections that are the same size as before, and I can keep them for as long as I need. I also still have full sensitivity.
My issue is sporatic, pulsating pains. They usually present themselves with very specific activities. If I don't masterbate I'm usually pain free. But if I allow myself to ejaculate, this is when the pains occur. But they never occur right away. Usually the pain is non existent the day/night of ejaculation, but by the next evening these pains will present themselves. Oddly enough, the pains are even worse the second evening following ejaculation, and sometimes sporatically occur for up to a week after ejaculation. It sounds odd, I know, but I've had 8 months to try this out, so I know this injury like clockwork. I've spent around 6 of those months conciously avoiding ejaculation in an attempt to heal.

However, at this point I'm starting to suspect that this could be a permanent, nagging problem I'll always have to deal with. Not masterbating at my age is difficult and probably not healthy. It's very depressing, because even now at 8 months out I know that if I do something normal like masterbate once or twice, the next few nights will be as painful as when I was a two months from my injury (not constant pain, but randomly pulsating, fleeting, nagging and annoying, and I feel if I become sexually active these pains will worsen). Immediately after ejaculation always feels totally normal and great, as does the hours following. But the pains always creep up the NEXT night and worse the night after. Pulsating, sharp and dull at the same time, but very fleeting and sporatic (glad its not a constant all day thing yet). Sometimes these fleeting spurts of pain are up to a solid 8/10 on the pain scale -something that would not be fun if it escalated, or if it stopped occuring sporatically and happened more constantly.

I realize there is no way for you to diagnose what happened to me based on these symptoms. Really what I'm looking for is what you feel I could do about it. It's 8 months in, I eat healthy, exercise and get plenty of sleep and conciously have tried for at least 6 of those 8 months to leave my penis totally alone and let it heal.

My three questions:

1). Could this be a nerve injury even though I have full sensation and can get erections? I personally suspect the injury has something to do with the sharp contractions of the penis that occur during ejaculations, but I don't know what could cause the 'lagging' effect of pain hitting me a day or two later.

2). What are some things a urologist might offer me to help heal? I'm very embarrassed about my penis and almost too afraid to see a real urologist and have his nursing staff perform a scan but maybe I need to. Do urologists have access to medicines/techniques that may aid in my recovery? Sure a guy can scan my penis, but do you urologists often follow that up with accurate diagnoses and some sort of anti inflammatory/medicine/etc to help with the healing issue?

3). How long should I wait until I accept this as most likely a permanent injury? 8 months is a long time for something to not improve much. My pains HAVE lessened and now only occur after ejaculation or periods of time where I contract the PC muscle for an extended time, such as during masterbation (in the very beginning the pains would happen even even without ejaculation). I've had surgery on parts of my body and they recovered within 6 months, but my penis seems much more slow healing than that after these jelqs. 8 months in and will go as long as I can, but life without sex or ejaculation is miserable I can tell you!

As a sidenote, I'm negative for herpes, ghonorrea, syphillis and a lot of other STD's I recently got tested for. I'm also negative for a UTI (no symptoms, and came up negative on a home urine test). I also do not feel I have prostatitis, constricted urethra, etc based on the symptoms I've read. I know this injury is a result of jelqing because the pains first occured while doing the jelqing exercises and have been present ever sense. I've obviously stopped penis enlargement exercises in the meantime, and have permanently ditched the jelq.

Sorry for such a long post, you are a hero if you actually respond!


Very concerned for my future sex life,
Michael

Answer
Michael:

Your symptoms are a bit odd for a jelking type injury.  To answer your questions:

Yes, it could be a nerve injury but I suspect there could be some other underlying problem like prostatitis.

Without any clear understanding of exactly what is broken, it is far harder to recommend a treatment.  There are no specific remedies for Jelking Injuries and nerve related trauma takes quite a while to resolve.  8 months may not be long enough.

You need to get over any embarrassment and go see a urologist. In most offices, all or at least most of the clinical assistants are female.  While we don't have specifics, we can check the involved area and review the available options.  In some cases, vitamin B-6 and/or daily cialis may be tried.  Anti-inflammatories may not be right way to go to improve healing, but they may provide some temporary help.

Again, it's impossible to say for sure how long to wait until the injury is considered "permanent", but I would suggest at least 1 full year and probably longer.  You've indicated that things are getting slowly better so it may just need some more time.

Technically, I'm not sure you have a penis injury but you may have an injury to some of the surrounding pelvic ligaments and muscles.

For now, try some extra vitamin B-6 and sitting in a really hot tub twice a day for 10 minutes.  This may help a little.

T

Urology

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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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