How to overcome a penile injury that worsens even after taking medications?

Hello doctor,

I read your query and understand your concern.

Has your penis changed its curvature since the injury? Can you feel a hard lump on either side of the shaft? Is the erection affected only during intercourse or during masturbation as well? I would suggest you get a couple of tests done and revert to me: Penile doppler test, and serum testosterone levels. In the meantime, I suggest you take a daily low dose of Tadalafil 5 mg tablet once daily before your dinner. Consult your specialist doctor, talk with them, and take medications with their consent.

Thank you.

Hi,

Welcome back to icliniq.com.

I see that I last spoke to you several months before and as you said the situation has not improved and has even gotten slightly worse. A penile doppler with an artificial erection is essential before we can think about treatment options as without a scan we do not know the reason behind your problem. You need to see a radiologist who can do the scan for you and give the results, following which a urologist will be able to help. Also, TSH (thyroid stimulating hormone). You need to specifically get serum testosterone done along with lipid profile and HBA1C. In the meantime, I would suggest you take 5 mg of Tadalafil daily regardless of whether you are going to be sexually active on that particular day. On the days you think you are going to be sexually active, I recommend swapping to 10 mg for that particular day. Only once you take it on a regular basis and you will get the true benefits of Tadalafil.

I hope all of this makes sense.

Hi,

Welcome back to icliniq.com.

The tests you have done do not include testosterone. You might want to consider getting that done. The lipid profile and diabetes workup seem to be fine though. The reason I am asking you to take Tadalafil daily is that over a period of time, the low dose of Tadalafil improves the circulation in the penis and helps with erections. It will not mask the problem, but help us figure out if you are responding to it and whether the problem is organic or functional. So my sincere advice would be to consider taking it every day for a short period at least. With regard to the scan with the radiologist, I am not sure about the local medical practice rules in your area. Where I come from, patients can just walk into any doctor's office and get a scan ordered by a doctor. I would suggest contacting a radiology center and asking if they would do the scan for you. You can always show them this chat or confirmation that a urologist has asked for the scan.

With regard to the alternative supplements you are taking, I have not found any literature backing their usefulness in treating erectile dysfunction. In my humble opinion, I would not put too much money into those, but then that is my personal opinion and preference. Vitamin E supplements on the other hand do have some role in improving the plasticity of the penis so you can try taking those instead. I am sorry to see that you have spent a lot of money on consultations already, so here is my suggestion: Take the Tadalafil daily until you can manage to get a scan. Even if you can manage to get a scan, the response to the medication may give us an idea about what is going on. Avoid using any traction devices on your penis, you may continue to use the pump though. You can revert back to me once you have the ultrasound doppler report.

I hope I have been able to guide you to some extent but unfortunately, without scans, we cannot really get to the bottom of the problem.