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Urology/Penis pump nerve damage

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QUESTION: Doctor,

I suffered severe dorsal nerve damage through use of  penis pump in June 2013.
And resultantly, for a whole year my penis went numb.

After 12 months of total numbness My penis now appears to have made a FULL recovery.
This has been the most psychologically distressing year of my life, I spent a whole year googling nerve damage, making desperate pleas on forums like this one,  and had to take 6 months off work with anxiety and depression.

I would like to post this question to reassure men who may be suffering the same numbness I have been suffering from. That even though it seems that your penile numbness will never fix itself, it will. But the damaged dorsal nerve of the penis recovers VERY VERY slowly, over a long period of time. And there will be times when you will lose all hope, it will recover!

The pump I used was a water based pump. And I will never ever use a penis pump again, they are extremely dangerous devices. Despite the recovery my foreskin is still numb( are the nerves there more delicate, doctor?)

In any case, I would like to warn men never to use a penis pump, it's just not worth it!

Many thanks doctor,

Michael

ANSWER: Michael:

In general, medical grade external vacuum pumps for ED are considered quite safe when used as recommended and as prescribed by your physician.  I am not familiar with any water based pumps.  Some numbness and bruising has been reported by some users, but long term nerve damage and numbness would be exceedingly rare.  The fact that you needed to take 6 months off of work for "anxiety and depression" suggests that there could have been some pre-existing issues before using the vacuum system which may have contributed to your problem.

Repair and cure of nerve damage to the penis can take quite a while depending on the severity and nature of the damage and the underlying causes.  It can sometimes take a year or more and there is never any guarantee that it will ever recover.

The foreskin is not necessarily more sensitive or delicate but may be more prone to damage from a vacuum system.

I would not agree with your statement about vacuum pumps for ED being dangerous.  Like anything else, they are considered relatively safe when used correctly under supervision.  Also consider that the alternatives to vacuum systems include drugs like viagra, penile injections, MUSE urethral suppositories and penile implants; all of which has potentially serious side effects as well.  

The bottom line is to become informed of the all the pros and cons of the various treatments available and choose what makes the most sense given your individual situation.  Also, make sure you get proper instruction and warnings about whichever treatment you eventually decide to try.

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

QUESTION: I have to say I have never expected to see such an ill informed response from
A consultant of urology.
"The foreskin is not necessarily more sensitive"
Peer reviewed clinical Research has proven a high concentration of distinct, highly specialized nerves in the foreskin.

You are also incorrect in assuming I used a vacuum device, I didn't , I used a penis
Pump. Again  The two are distinctly different devices. So you have already departed from
the issue. A vacuum device is used for a few humble seconds
To facilitate an erection, a penis pump is used for up to fifteen minutes a day to increase size and girth. This is a very serious
Issue which Has the potential to ruin the lives of many men, yet you are treating it with a great
Deal of levity.

Also nowhere in my question did I advocate using Viagra, muse, or penile implants, nor did I refute their side effects,
.so this is not germane to the discussion.

With the greatest of respect you appear to be disconnected from the issue and out
Of touch with current developments and research in neurology, as well as
Basic anatomy of the penis.  And I feel your answer, for an expert, displays
An astonishing level of ignorance.

Thank you for taking the time to respond, but I have not benefited a great deal
From your response at all.

ANSWER: Michael:

I misunderstood your question.  I have not encountered a water based penis pump for penis size enhancement and thought you were referring to a standard external vacuum pump for ED therapy.  Now that you have clarified your issue, I'll modify my response.

I actually agree with you that penile pumps for enlargement are potentially dangerous.  Just review this forum and you'll see many questions about recovery from damage after using such systems.

The response I gave you was correct regarding EVD systems but did not refer to the penis enlarging device you had used.

The issue of foreskin sensitivity is somewhat controversial, but I stand by my original statements.  Since the foreskin has no internal cavernous vascular material like the corpora, it's just two layers of skin, and even if the skin surface is sensitive, there is no vascular space to become as engorged as in the erection bodies.  Therefore, the foreskin is less likely to be damaged from the various pumps, stretchers and vacuum devices avialable.  As far as the recovery from penile nerve damage, there also I agree with you.

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

QUESTION: Hi Doctor,

I apologize for the misunderstanding on my behalf, and also for coming
across as rude.

I think this is an unusual problem which unsurprisingly many people
,even experts in urology/neurology have not had specific experience of.

Sexual dysfunction still seems to be a taboo in the medical community.
And many doctors are in the dark when it comes to specific sexual problems. Where there is an overlap of disciplines such as neurology and Urology, things get very binary, and the respective experts only seem to be able to comment on their own field. (eg a neurologist knows a lot  about nerve problems in general, but not of that in the penis) , and conversely a urologist can tell me I've damaged my penis, but is not an expert in  nerves.
 

Thank you for taking the time to respond. I've found the last paragraph of your response very helpful.
In the politest sense I'd like to add that the foreskin contains a continuation of the dorsal penile nerve, within which it branches out
into fine touch receptors and nerve endings which are specialised to detect stretch and fine touch, this is part of the argument against circumcision, a lot of sensitivity is lost.
Regenerative medicine is currently attempting to regrow this structure for men who have been circumcised.

Thank you for your time and advice.

Answer
Michael:

That is also part of the problem since it's not possible to do a reliable before and after circumcision test.

Let me pose the problem to you this way.

1) I have yet to encounter a man where the loss of foreskin sensitivity alone was enough to cause ED or substantial loss of sexual pleasure.  Possible I guess, but I've been in practice over 30 years and have yet to see it.

2) Look at all the problems that occur without a circumcision.  Phimosis (narrowing of the foreskin), paraphimosis (where the foreskin is trapped behind the head of the penis and slowly constricts causing strangulation of the head of the penis), balanoopisthitis (bad infection behind the foreskin), HIV and HPV infections (much reduced with circumcision) and penile cancer (while uncommon, it is totally preventable with circumcision).  These are reasonable medical reasons to do a circumcision even if there is a small reduction in sensitivity which remains controversial.

I have a patient who has metastatic penile cancer.  He may have a year or so to live, but the end of his life is likely to be very unpleasant.  Totally preventable if he had undergone a circumcision at birth.  That's a rare case of course, but tell that to his family.

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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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