Dr. Purushottam Sah
Obstetrics and Gynecology
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 having a problem with my penis. It feels hard like a hard rubber tube even while flaccid. The veins have also become very prominent. Sex is now painful and my penis becomes sore and red after intercourse. I had all the tests done. All STD tests came out negative. The problem has been for six months and none of the urologists that I have been to are able to tell me what it is. I am getting erection, but I am unable to maintain it. I have also noticed that since this problem began I have started to sweat profusely during stressful situation in my daily life. Is this a stress or pelvic floor related issue? Please help me out as this is affecting the sexual health of my marital life.
Hi,
Welcome to icliniq.com.
I have read and understood your problem. You have not mentioned what all the tests you did. You have mentioned only STD tests (sexually transmitted disease). It appears to be due to stress or anxiety, so do relaxation exercise. However to exclude other cause, you need to do some blood tests like Hb (hemoglobin), TC (total blood cell count), DC (differential count), fasting sugar, creatinine, prolactin, TSH (thyroid stimulating hormone) and testosterone. You should get an ultrasound of prostate and 2D plus Doppler ultrasound test of penis to detect any plaque or venous thrombosis. Stop smoking, if you smoke. Check BP (blood pressure). If you are taking any medicine or nutritional supplement on regular basis, then it may be due to side effect of that. Since sex is now painful and penis becomes sore and red after intercourse, you should use condoms for some time to remove the chance of inflammation caused by any allergy or subclinical infection.
Patient's Query
Hi doctor,
I have done a urine culture test (negative), STD test (negative), penis and prostate ultrasound for fibrosis (negative), and thyroid ultrasound (negative). I had to have five courses of antibiotics taken to rule out any potential STD's (Azithromycin, Doxycycline, Cephixime, Ceftriaxone injection, and Avelox). A Urologist even suggested it could be epididymitis. I have attached a lab test for the hormones tested including testosterone and prolactin. I take a small dose of Bisoprolol (beta-blocker) for my BP (140/80). In addition to the excess sweating, penis hardness and soreness (as can be seen in the first photo) my groin area also feels relatively warm compared to the rest of my body. I do not have a problem urinating though. Please advise on what to do. I have been to four urologists but the problem has persisted for so long. If it is stress-related, what relaxation exercises would you advise and how long will it take to recover? Is excessive sex or masturbation a reason? Should I avoid sex for a while?
Hi,
Welcome back to icliniq.com.
The reports that you sent are fine (attachment removed to protect patient identity). In my opinion, your symptoms resemble those of Peyronie’s disease which is in its developing stage and in many cases it is caused by beta-blockers. Since your tests are normal, your problems may be related to beta-blocker. Groin and armpits are usually warmer than the rest of the body. I do not suggest stopping sex or masturbation but it depends on how comfortable you are. Relaxation exercise includes lying still and taking slow breaths in through nose and breath out slowly through the mouth. Swimming is also good.
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Obstetrics and Gynecology
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