I have ED and a pain in my penis. Please help.

Question

Hello doctor,

I am a 24 year old male, suffering from ED since the last one and a half years. I have gone through penile doppler thrice. The test which I took one year ago showed the PSV after 20 minutes as 38 cm/s, the EDV as 0 and the inner caversonal diameter was .15 mm and after the injection it was .70 mm. After the doctor had seen the reports, he advised me to take Tadalafil 10 mg and to masturbate after taking it. While masturbating, on the third day, I got pain in my penis, and it was in the middle of the shaft of the penis at the thumb point. I visited the doctor again, and he prescribed Polycovit, Mynubin-P, Zanocin 300, Trental 400 mg and I also masturbated four times a week. But still, the pain continued. So, I went through the test again eight months back.

The value of PSV was 25 cm/s and EDV was 0, but the inner caversonal diameter changed to .44 mm pre-injection and after. The third time I underwent the test again. The values were normal at 25 cm/s, and EDV at 0, and the inner diameter was .6 mm and after injection at 1.2 mm. I still have the pain in the penis at the same point. It has now been a year since the pain has started. There is no bending during erection, but there is a deformation in the penis like an hourglass shape and hard flaccid. Now, I masturbate only once a week. Is the 25 cm/s good or does it mean an arterial insufficiency? Does Peyronie's disease obstruct the blood flow in the penile doppler? I have no diabetes, no cholesterol, and I am not a smoker. I want to know why the flow is less.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern. If we consider the results of the Doppler:

The first test revealed normal parameters. The PSV was absolutely normal. The values second time around were PSV 25. This is also normal, though it is in the low range. But, that cannot be used to label it is as an arterial insufficiency.

Now coming to your problem of erectile dysfunction and pain at the site, do you have pain during sex also or during masturbation only? Is the pain at the site of injection or is it a vague pain?

During Doppler, a small hematoma can form at the site of injection, which later becomes a localized swelling and causes pain. But, that should be ruled out by a surgeon. Since there are no risk factors and no definitive anatomical cause, we can label this pain as occurring due to that localized swelling.

For erectile dysfunction, you can continue to take Tadalafil 10 to 20 mg on an SOS basis. I suggest you take supplements containing L-arginine and Yohimbine as this will make the erection stronger. Antidepressants like Bupropion also have a great efficacy in psychogenic erectile dysfunction. Bupropion not only relieves anxiety but also has a positive impact on the erection.

So please discuss with your doctor about these drugs. Do not get stressed. Your PSV in the last test is normal and is not suggestive of a vascular insufficiency. The values do not remain same always and may come normally in the next test. Take care.