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Urology/Erectile Dysfunction


Dr. Leslie,
I am 25 years of age, have some a history of abusing alcohol in acute periods, have a history of acute alcoholic gastritis as a result of this, use recreational drugs occasionally, non-smoking, suffer from bronchitis yearly with a persistent cough after, no allergies,  am moderately healthy otherwise, play sports effectively, and have no history of diabetes or blood pressure related issues.

A year and a half ago, approximately 14 months, my girlfriend at the time and I were engaged in intercourse when I jammed myself into her leading to immediate loss of erection with some soreness, no bruising, bleeding, or popping sound occurred to my knowledge, and no immediate curvature changes. The next day I was able to achieve an even greater erection than usual, and at some point that day it was bent down uncomfortably between my legs further than desireable, which also caused a loss of erection. We were not careful with sex to say the least, but that particular weekend marked the acute beginning of my troubles.

Over the course of a month or so I realized that I was unable to achieve erections as usual, sort of "half mast" erections with much less stability and with no real "locking in"aspect to it. I also noticed that I was experiencing greater curvature (to the left) starting at the base, less that the shaft itself was more curved, but that it aimed further left than before, almost leaning weakly at the base rather than stable and upright. To illustrate, I used to be able to put a towel on my penis while erect with no issue or pain. Now I fear I would break it off. I had some numb feeling soreness in the shaft and base and some rigidness while flaccid, with fewer/weaker morning erections. Im sure this was psychologically affected to some degree.   

When I would have intercourse over the months following, I had much more difficulty achieving erections, I would feel sore during and after sex, as my penis didn't seem to be as fully hard or sturdy as it used to become quite easily. I was far more sensitive to any mild jamming and bending. I also noticed that orgasms were almost numb or otherwise delayed, and occasionally caused some pain near the base of my penis when ejaculating. My penis would quickly become flaccid but stay hard and turtle up for a while (this is the same after masturbation).

I went in to see a Urologist, who gave me a month sample 5mg daily dose of Cialis and instructed me to take 200mg of Ibuprofen three times daily and potentially try using an extender for a while for the curvature, and not to avoid sex or sexual activity, believing that my symptoms would improve completely given time. He did not observe anything in examination that concerned him regarding physical injury, other than that it was essentially turning more left at the base according to my observation. During this time I was able to achieve much harder erections adequate for intercourse, but felt that although it solved my ability to become hard, I still had issues with soreness especially at the base, general leaning left and numbness especially at the tip. after a month I saw him again and was given more cialis to take every other day for 2 months. He told me not to worry and to give it time.

So I decided to wait about 9 months and hope for the best. I ran out of cialis of course, had very dissatisfying and infrequent sex with my now ex, and I am still suffering many of the same underlying issues, some of which had become slightly worse. I returned to him and was given a prostate massage (which may or may not have helped) where he observed a slightly "spongy" but maybe not overly enlarged prostate. I was asked to do some other lab work, including a urinalysis, PSA, and free and total testosterone, which all had normal results. Upon return he gave me another pack of Cialis (which is the only way I can achieve useable erections at this point) and said there was nothing more he could do.

Dissatisfied, I visited another urologist in the area who sent me to do an Ultrasound, which I had done today. I stopped cialis for 5 days prior to ultrasound, and my functionality is back to weak and almost slightly bendy and unstable erections. The person administering the ultrasound said it seemed that the results appeared normal (they did not inject me with anything to make me erect as I had read somewhere), so I'm optimistic that I don't have any vascular blockages or issues in my penis. That being said, I'm still very distressed about the issue as a whole, as it has cost me a meaningful relationship and a whole lot of confidence and optimism regarding my future.

My current symptoms include:

Difficulties achieving and maintaining erections adequate for enjoyable sex, particularly while standing
Curvature while erect starting at base (leans limply left)
Instability while erect (able to move from side to side very easily, unlike before where more sturdy)
Heightened sensitivity to ANY jamming or bending during intercourse or masterbation
Penis becomes hard flaccid and curves DRAMATICALLY more left when flaccid after use
Soreness at base, up the middle of shaft, and between scrotum where penis is inside the body.
Occasionally delayed orgasm during ejaculation and always overall reduction in sensation
Erections + urination while voiding (more regular with cialis)
Changes in urination tendencies, more frequent, less, difficulty and some general sting during urination
Some stinging at tip and pain while ejaculating/urinating (like its pushing through some kind of barrier in my urethra near the base)
Serious stress and depression over these symptoms which may further complicate the situation

Potential diagnosis I've come across (if others can be effectively ruled out):

Inflammation (possible cause of scar tissue build-up)
Chronic constriction of pelvic floor? (not sure I understand this one)
Pulled or torn suspensory ligament
Anxiety and depression, psychosomatic (most likely compounding with the underlying issue)  

I believe I have listed my history and symptoms sufficiently, if any additional information is needed please let me know. Through my inquiry I'm hoping to receive a few possibly diagnosis with available tests that might help to confirm them, potential treatment options, and perhaps an approach I could take with my urologist to make sure we rule out what can be ruled out and identify the underlying causes of my symptoms.

Your support is greatly appreciated! Sorry this is so horribly overwritten. It is an issue I'm far too familiar with at this point. Thank you.



You clearly have ED which fortunately responds well to cialis. There is some  curvature and soreness as well as some psychological issues.  There is no magic test to verify a diagnosis beyond this. You should take advantage of what is working for you and follow the advice of your physicians.


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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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