Dr. Madhav Tiwari
General Surgery
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,
I am a 20-year-old male experiencing flaccid penile pain and curvature, which has prompted concerns about Peyronie's disease. After consulting a urologist who palpated my penis and ruled out Peyronie's, I am still experiencing these symptoms. My penis is straight when fully erect.
Additionally, I am facing erectile dysfunction (ED) issues, lack of morning erections, and inconsistent nighttime erections. My erections are satisfactory when lying down and manually stimulating, but I quickly go flaccid upon standing or without manual stimulation. Some days, I struggle to achieve an erection even lying down. This has been ongoing for eight months.
Your insights would be greatly appreciated. Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I can understand your concern.
I am sorry to hear about your troubles. Kindly help me with a few details so that I can understand your issue better:
Are you diabetic or hypertensive?
Have you had any surgeries in the past?
Do you have any pain when you have an erection?
Do you practice prone masturbation?
Are you any form of medication at the moment?
Do you smoke cigarettes or marijuana?
I can not see any issues with the erection in the photo (attachments have been removed to protect the patient’s identity) that you have uploaded and a negative physical exam is pretty accurate to rule out Peyroni’s.
I hope this information will help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
I do not have diabetes or high blood pressure, have not undergone any surgeries, and do not experience pain during erections. I used to smoke but stopped a year ago. I am not on any medications.
Thank you.
Hi,
Welcome back to icliniq.com.
I do not believe there are any Peyronies based on the history and photos you have provided. I do think this problem may have something to do with prone masturbation. Prone masturbation does cause men to have less intense orgasms when they stop doing it.
This is because many men report enhanced orgasms from prone masturbation. However prone masturbation may be very harmful for you. It may damage nerves if done too aggressively. I do not believe there is any nerve damage in your case as you have normal erections.
I advise you to get a doppler ultrasound of the penis to make sure there is adequate flow and no Peyroni’s plaque.
Once that is done we can have you on a tablet of low-dose Tadalafil to help you with your erections.
I hope this information helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
It is difficult to get a urologist appointment in my place. I had to wait for three months to get an appointment the last time. The specialist said it was not needed for a Doppler ultrasound. What concerns me about my erection is that I am not having a morning erection, which is not normal for a 20-year-old, I am also having problems when masturbating so I am afraid I have a physical problem and not a physiological problem. I fear I have a venous leak. Could prone masturbation cause venous leaks? Kindly help.
Thank you.
Hi,
Welcome back to icliniq.com.
I believe there might not be a physical issue because, in one of the uploaded photos (attachments have been removed to protect the patient’s identity), I noticed a normal-looking erection. Morning erections can occur without you being aware of them, happening during deep sleep.
The reduced sensations might be linked to prone masturbation. It is known to diminish sensitivity, and those accustomed to it might find it challenging to enjoy conventional masturbation.
Confirming a physical issue typically involves an ultrasound, and medication might be an option afterward. However, prescriptions like Tadalafil should be discussed with a healthcare provider. They can evaluate your situation and, if appropriate, prescribe medication like 5 mg of Tadalafil for a trial period.
Kindly consult a specialist, talk to them, and take the medications with their consent.
I hope this information helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
I have 5 mg of Tadalafil pills sufficient for two weeks. Should I start taking it? I stopped getting erections at all even when lying on my back for a week.I could get an erection on my back and maintain it previously even though I was suffering from ED, but now I can not.
I also noticed that my penis curves and makes weird shapes when semi-erect. If it is fully erect then it is normal and there is no curvature. I am panicking and I do not know what to do. Do you think I have pelvic floor dysfunction that causes curvature and weird deformities when getting an erection? Or could this be due to my stress?
I would like to know if prone masturbation damages the veins of the penis and cause a venous leak? Kindly help.
Thank you.
Hi,
Welcome back to icliniq.com.
Pelvic floor dysfunction does not cause penile curvature. It is very unlikely that prone masturbation would have caused the venous leak.
I hope this information will help you.
Thank you.
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General Surgery
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