HomeAnswersUrologypenile disordersMy hourglass-shaped penis experiences poor erections. Help.

What could cause hourglass deformity in a penis?

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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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Published At May 3, 2023
Reviewed AtJanuary 17, 2024

Patient's Query

Hello doctor,

When my penis is flaccid, I get an hourglass-pinching effect. It is quite severe, though, slightly more pronounced on the left side. It is most common when semi-erect, but is also very noticeable when fully flaccid or when I am cold, or holding in urine. It is not only an hourglass shape with a weak flow in the center but changes with an unequal shape also. There is definitely an issue with blood flow overall, and my erections are less strong and lasting. Although there is no pinch when fully erect, only a slight favor to the left which is not normal for me. I have seen a urologist who quickly diagnosed it as Peyronie's disease but without looking at it. He said that there was nothing that can be done. After this, a general practitioner sent me for imaging. They did not see any plaque which makes me think maybe this is not Peyronie's disease.

I went to a men's health clinic and had shockwave therapy, p-shots, and stem cells injected into it which did help with the blood flow temporarily. The doctor did hear blood flow issues when he listened during my examination. For a brief time, the hour pinching when semi-erect was less noticeable but did not disappear. I have found many men online in forums with this same issue. And came across articles and forums describing the condition called hard flaccid, which also seems to be related to my problem. I am 35 years old and very fit but I have had this issue for years now. I can definitely send pictures if you would like. I would very much appreciate your help on this.

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Peyronie’s disease is fibrosis in a part of the tunica layer around the corpora and that fibrosis usually creates an angulation at full erection to a variable degree. Usually, if this angulation is less than 15 degrees we just reassure and do not treat. Intralesional injections of collagenases would help mild degrees of angulation. But as you mentioned there is no noticeable angulation on full erection, therefore in my opinion you do not need treatment for that. MRI (magnetic resonance imaging) scan of the penis would tell more about this hourglass lesion in the penis for accurate diagnosis.

If you have any more questions please feel free to ask. Also please feel free to share pictures of flaccid and erect status.

Hope this helps.

Thanks and take care.

Patient's Query

--file attached-- Hello again Dr Altawil. Thank you very much for your reply. I decided to take some pictures for your reference. I probably sent more than needed but I'm not sure what you'll notice here, and it's form changes so much. The pinched area will lose all structure and strength so that the bottom half bends ands twists separately from the bottom. It is very uncomfortable. The pinch is offset on either side but it seems to go all around the shaft. There is a slight bulge on the right side. This happens randomly at all stages of blood flow except for full erection. Although I do notice a slight difference along the sides, it's not as smooth and uniform as it was. The pinch will also become far more extreme than the pictures I have taken, especially when I'm cold and wet, like hopping out of a pool or holding in urine. Could this be something other than peyronies? Like a venous leakage I have read about? Or damaged arteries? I think I notice it more when blood is leaving, but not always I guess. Is it possible to damage the muscles themselves, rather than a plaque buildup? I feel terrible making you view these. But is there anything at all that can be done? Would those shots help? Am I wasting my money on stem cells? This really bothers me unfortunately. Thank you kindly Dr Altawil.
Hi and thanks for follow up I saw the pictures and if there is no deformity on full erection then no worries no Peyronie’s disease. Peyronie’s disease is fibrosis of the tunica albuginea and that cause deformity increasing and gets more obvious with erection. Your condition is normal and doesnt really require treatment. And no venous leak as venous leak prevent erection. Prp or even stem cells can help in erectile dysfunction which i dont think is the case with you. If you any more questions please let me know Kind regards

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Samer Sameer Juma Ali Altawil
Dr. Samer Sameer Juma Ali Altawil

Urology

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