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Urology/Penile problem


Dear Dr. Leslie,

Many thanks in advance for your consideration in response, especially given the personal subject matter.

As a circumcised male in twenties with no recent sexual partners, three months ago I had masturbated and woke up the next morning with a paleness around the farther end of the penis shaft, though the head and nearer part looked normal.  Over the next few days the paleness remained there but also seemed to become wrinkled as the whole penis basically contracted and shrunk.  As Iíd used soap as a lubricant, initially I thought it was because of neglect in washing it completely clean.  Nothing else seemed different about that time other than it not lasting long at all.  

Over the next weeks I didnít notice much change.  The pale portion appeared to be a little swollen.  Iíd seen physicians and tried a couple creams, corticosteroid and antifungal, though neither seemed to help much.  

After a month it appeared to be gradually moving in the right direction, slowly returning to normal size, though the texture and paleness more or less remained.  Thinking it had been because of soap and not more, I had done the same thing a couple times the next month, without soap, no issues.

A couple weeks ago I did so again, perhaps lasting longer and not as careful.  Afterward I noticed some irritation, and the next days were similar to those after the first time - all much smaller again (and wrinkled/pale over the same part), so it must have been the masturbation that did it.  However, this time I was alarmed that it seemed different, less there, and I was unable to get anything close to an erection afterward.  For a full week nothing, and then only sort of but not fully on a morning or two, never otherwise, even still.  The first time this was basically unaffected.  (Though I have had a nocturnal emission or two since the second time.)

After this time, aside from that, I also noticed that it was often sort of frozen in place when flaccid, and seemed to lean left too.  There was intermittent discomfort or very mild pain there and also in the testicles, which had swollen (sometimes in the abdominal region too).  I also noticed a slight pause or wait to urinate at times, no pain, but also maybe less forceful than before.

I was worried something serious had happened and saw a urologist, though he mostly seemed to brush off the concern and say things will eventually return to normal.  My urine sample was apparently fine.

At one point I noticed the circulation seemed to be affected, as the head became darker and the pale section became lighter, the whole thing shrank further from its already smaller state, though this passed after a little while.

My position seemed to change it, with lying down helping to improve, and together with the swelling and occasional pain in the testicles, thought it could be all due to inflammation there and began icing / elevating that along with taking an anti-inflammatory.  This seemed to return it almost to normal, apart from not having erections and the slight shift left.  As I still had some discomfort in the testicles, I started an antibiotic thinking it was epididymitis, but now this seems wrong, as the antibiotic seems obviously to have shrunk the penis again / made its texture less normal after only a couple doses, for whatever reason.

Now my worry and best guess is that itís something with ligament damage.  Could you say if this or something else seems likely from the description?  I didnít know if that could tie in to the scrotal discomfort, if anything else would help recovery - icing the penis or medicine or anything - and if care is needed, how urgently.  Does it sound likely to heal from this at all on its own, and how long could that take, or to what extent might it recover, as itís basically always been flaccid since almost three weeks?  I wasnít sure if a penis/scrotum ultrasound is worth it to check, or if that wouldnít show everything - or if surgery might be necessary.  Could fertility be affected?  And I havenít been doing any running/cycling/exercise to bother it - could I start to again?  Trying not to worry.  Prior to this Iíd planned on traveling soon for a week or two, suppose itís fine to go ahead and do so.

While I realize itís tougher without an in-person exam, Iím really grateful for any answers you may be able to suggest.


This does not sound like any obvious clinical disorder I can identify. It is not ligament damage, for example. Without a better diagnosis it is impossible to answer questions about prognosis, fertility or recovery. I can only recommend a second urologic opinion.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


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.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

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.

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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