Dr. Raveendran S R
Sexology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My penis has a mild curve to the left. On the top left shaft under the glans, an unknown stiff body was identified in the ultrasound. While having intercourse at 80% erection, I felt slight tightness on the right side of my penis. A day later, I had potency issues for two weeks, even with tablet Cialis 7.5 mg. After two weeks, when the erection came back normally, there was mild pain with soreness on the base of my penis. This pain then moved to the left side and developed to full-time pain, including the area below the gland. The pain is felt in the flaccid state only. After taking tablet Dicoflan 75 mg twice daily and Cialis 5 mg once a day for five days, all the pain was gone. After that, I had sex three times, and the pain did not come back. As there was on and off penile pain after intercourse, my doctor asked me to retake the medication and recommended shockwave therapy. Kindly suggest suitable treatment. Thanks.
Hi,
Welcome to icliniq.com.
I can understand your concern. I checked your reports (attachments removed to protect the patient’s identity). It is not filler related condition. Hence, we need to consider other causes. Unidentified matter can be granuloma, but it is not dangerous. Granuloma will not cause any illness but can cause discomfort. Next, the best action is shockwave therapy. But make sure to have lubrication before sex and increase foreplay during sex to get natural lubrication. Thanks.
Patient's Query
Hello doctor,
Thanks for the reply. Can it be a starting stage of Peyronie's disease? If yes, then what to do about it? There is mild pain and burning around the unidentified object. What medicine should I take? Thanks.
Hi,
Welcome back to icliniq.com.
Since you have issue only during a dry sex, you need to make sure that you are well lubricated before sex. Shockwave therapy is needed only if there is a persistent pain. But your pain is only during a forceful or dry sex. So, you can wait for few more days and decide regarding shockwave therapy. It can lead to Peyronie's disease if there is persistent injury to penis in a given area. So, you need to reduce dry and forceful sex. It usually takes three to six months to heal. I suggest you to take tablet Diclofenac or Zerodol-P (Aceclofenac and Paracetamol) for your pain. If the pain is severe, you can take steroids. It is advisable to do CBC test (complete blood count) and CRP (C-reactive protein) test to rule out the cause. Regards.
Patient's Query
Hello doctor,
Thanks for the reply. I will continue taking Diclofenac for three more days. But if the pain persists, what can I take? When to do CBC and CRP test? Can shockwave therapy break down calcified substances? Is shockwave therapy suitable for phase 1 Peyronie? Will shockwave therapy make the granuloma worst? What shall I look for if this is a Peyronie's disease developing? Thanks.
Hi,
Welcome back to icliniq.com.
You can continue Diclofenac for the long term, but it can cause gastritis in a few people. You can continue it if you do not have such an issue. If there is an active infection or inflammation, we can identify it with CBC and CRP reports. It is not a specific test for Peyronie's disease. If you have Peyronie's disease with pain, then your CRP will increase. Yes, you can use shockwave therapy to reduce pain, and it also helps in healing and gives a better erection. Yes, it will help reduce pain and heal the vascular injury. Shockwave therapy will not worsen a granuloma. Kindly look for pain. Take care.
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