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Hi Doc,

I'm 25 years old 6'1 190 pounds with no health problems and not on any medications. 5 months ago I was having sex with my girlfriend in the missionary position for about 10 minutes pretty vigorously using a condom when all of the sudden I lost my erection. I didn't think much of it at the time but the next day I was unable to get an erection, my penis and scrotum were completely numb!
For the first 2 weeks my penis was very sore as well but no swelling but I did develop a bruise (purple mark) where my glands begin which I still have now. As well as a slight bruise on the top shaft of the shaft and a line that starts at the foreskin all the way down the shaft appeared.
I did have burning when I pee and a weak stream when urinating felt like I have to force the pee out. I went to see my doctor got checked for stds and took blood for diabetes and everything was fine. He was very unsure what the problem was he thought it was a pinched nerve but from reading on the internet I believe I bruised the dorsal nerve in my penis.
Fast forward to today I have 100% sensation on my scrotum and the shaft of my penis. My urine has no problems and has returned to normal. I have just recently developed more feeling in my glands which I hope keeps improving in the next few months. Everything seems to be healing fine but my main problem is getting erections. I get morning erections everyday (which I had absolutely nothing at the start of my injury) now and the quality of them are very good, but other then that it is very difficult to get an erection by touch or visual stimulation.
I have no problem ejaculating when I do get an erection. My question is do you think my erections will slowly return to normal as the sensation in the glands return? Are my erections harder to get because of the nerve damage/lack of feeling? Should I stay away from sex and masturbation til everything heals? I don't have anxiety or depression, I'm trying to stay very positive about this and slowly let it heal. I have been taking b6 everyday and taking hot baths to try to help with healing.

Thank you so much for your time,

John

Answer
John, at this late date from the onset of your problem, it is difficult to say for sure what is going on.  I suspect that during the initial event where you lost your erection, that you probably suffered a mild so called "fracture of the penis".  Yours is not typical as these usually are accompanied by a "cracking" sound.  To follow is my "macro" of this condition.

Penile fractures are very obvious.  They generally occur when while having vigorous intercourse, on thrusting inward, the penis misses  the vaginal opening and forcefully strikes your partner's pelvis.  This is accompanied by a cracking sound, similar to snapping a twig.  The penis immediately becomes limp, swollen and bruised.  The fracture is actually a tear in the membrane around the corpora cavernosa (erectile body).  Minor tears may heal without treatment but larger ones are best repaired surgically.  If left alone, the scarring that occurs during the healing process, may cause some future curvature of the penis with erection.   However, with minor tears this is not generally a problem that in any way interferes with normal sexual activity.  This problem would account for the soreness, numbness & bruising.

The urinary symptoms were most likely due to mild inflammation of the prostate gland - so called prostatitis.  Sexual arousal without ejaculation often precedes this.

At any rate, you seem to be getting better over time and I suspect this will continue until your are 100% normal again.  I would recommend that you ejaculate 1-3 times a week just to keep your prostate decongested and healthy.  It is okay to have sexual activity (masturbation and/or intercourse) but no rough sex.  The use of a good quality lubricant (such as the "silk" lubricants) is advised to lessen the chance of further injury.  

At this point in your recovery, I do not think the B6 or hot baths are of any further value.  One last point, if you are a bike or horse back rider, I would stop this activity until totally better.  Pressure on the perineum can cause numbness and problems with erection due to compression of the penile nerves that run through that area.

Good luck.

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Arthur Goldstein, M.D.

Expertise

Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.

Experience

I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

Organizations
American Medical Association, American Urological Association, American College of Surgeons

Education/Credentials
College degree - BS Medical degree - MD Master of Science - MS

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