Main Symptoms:
-retracted, hard flaccid penis. resists stretching and remains seized up unless exposed to heat for a generous amount of time
-flaccid penis feels lighter, almost weightless at times
-tightened scrotum
-reduced erection quality. harder to get erections and erections subside quickly without stimulation.
-tight, constricting feeling when erect
-slight reduction in erect length. often times slight reduction of girth.
-indentation on one side of penis, usually the left side. more pronounced when transitioning between flaccid and erect (getting a semi hard-on)
-reduced morning erections and spontaneous erections. morning erections are poor quality and can be very infrequent or never
-cold glans and scrotum
* all symptoms seem worse when in the standing position. everything seems to loosen up a bit and erections are better when sitting
Other Common Symptoms:
-reduced shaft sensitivity (penile numbness)
-penis head won\'t fill up during erections
-weird reaction of penis when flexing PC muscle (jerking motion rather than filling the penis with blood)
-tightness in perineum
-reduced sex drive
-difficulty urinating/ increased urge to urinate
-different feel to the skin in the genital area, softer and thinner
-reduced testicle size, joint pains, fatigue
Now let\'s talk about the causes of this condition. At least a few of these should sound familiar to you by now:
-stretching the flaccid penis causing a popping sensation at the base of the penis on one side, just inside the groin area (most common). This causes a frightening retraction of the penis into a small, hard and shriveled state
-injurey during sex or jelqing, can include the same popping feeling as above
-vigorous, prolonged masterbation session.
-injury to the perineum area or base of the penis
Right from the outset of my research, I have found that no one has had legitimate success with visiting a urologist. Ultrasound testing shows nothing out of the ordinary, and people are told that there is nothing wrong with them (or worse, it\'s in your head). I have not been to a doctor about this as I had no reason to suggest I would have any more success than the next guy (the symptoms of the condition are remarkably consistent among everyone afflicted)
How I made a mild improvement:
The overall tightness in the genital-perineum region seemed directly related to the severity of the symptoms. I found that my perineal muscles, such as the PC were chronically tense as if my body was bracing for the next trauma to the area. I focused on relaxing my pelvic floor for a night. It is tricky at first but gets easy with practice. Think of it like a reverse kegel, but don\'t put much force into it, just let the area kind of relax. It should feel like the entire region lowers and loosens a bit. This method will allow your penis and scrotum to hang a little lower and will improve erections a little. When sitting down, my erections feel more or less normal because the area is maximally relaxed. Problems continue when standing. This is no cure, but it helps and it did offer insight as to what the structural problem might be.
Nature of the problem:
Most of you are probably experts in male reproductive anatomy by now. I know that I have wasted countless hours trying to find anything that might hint at the cause of the problem. Let\'s consider the instance of injury by stretching. When stretching the flaccid penis, you are elongating several fascia. In order of deep to superficial they are the tunica albuginea, Buck\'s fascia, and Colle\'s fascia (continuous with the dartos tunic and the superficial fascia of the perineum, it is essentially one big sheet). Most people seem to think the problem is with the deeper fascia of the penis, and that there is an injury somewhere along the length of the penis. There isn\'t.
All of my searching has led me to conclude that the injury is to the superficial fascia of the perineum and penis, which are the same thing and can be referred to as Colles\' fasica. The popping feeling many of us felt at the time of injury was this membrane tearing. The defensive retraction of the ruptured fascia is what caused and continuous to cause the constricted flaccid penis. This damaged fascia resists the tendency of the penis to loosen up when flaccid and to grow when erect. The change in appearance of the penis in the days and months following the injury is damage to the fragile tissue between colle\'s fascia and buck\'s fascia, known as areolar tissue.
Many people, including myself, complain of reduced \"force\" of erection, or the decreased resistance of the fully erect penis towards being pushed downwards. I think this is because of some loss of support form the fascia injury. Think of loss of tensile strength of a ripped cloth.
My injury was caused by accidentally swinging a small dumbell into the interface between the left base of my penis, the scrotum, and the perineum while exercising. I am 23 now. I experienced the infamous popping sensation and immediate flaccid regidity. I will periodically get a wierd pain in the left base of my penis, but also have pain in the left side of my perineum when I palpate it. Intriguingly, I have a tender small mass in the rear left of the perineum close to the anus, in the area where colle\'s fascia attaches to the pubic bone.
Why this is a more serious problem than you may think:
Besides the crappy erection quality, there are a lot of other negative things happening because of this simple injury. The fascia of the pernial region are more or less all connected to one another. The abnormal retraction of the damaged colles\' fascia strains the perineal membrane (to which it is connected), resulting in many of the most common symptoms. Here is a list of what important structures pass through the perineal membrane and into the space above colles\' fascia and a description of what happens to them when the membrane is constricted.
Deep arteries of the penis- restricts blood flow to the penis, causing a very small flaccid and cold penis
Dorsal arteries of the penis- same as above
Dorsal nerve of the penis- loss of sensation when in constricted flaccid state
Urethra- difficulty with starting urination
Between the perineal membrane and the superficial fascia of the perineum lies the internal pudendal vessels, which supply blood to the scrotum and the penis.
The danger for us lies in the fact that prolonged contraction of these fascia resticts blood flow to the entire gential region. There are reports of testicular shrinkage and continuous penile shrinkage. When the genital and perieal area are totally relaxed, the problem is minimized, but the majority of the time , for us, the areas are far from relaxed. Symptoms are worst after ejaculation, when there is a natural explusion of blood from the area and retraction of the penis.
The blood flow problem explains why L-arginine is beneficial for reducing symptoms. The extra NO produced from the arginine relaxes the blood vessels in the region and allows more blood to get to the penis while both flaccid and erect. L-arginine has helped me a little, but it obviously won\'t fix any structural problems.
What we can do:
We need to stop looking at this as a penile injury and more as a lower groin injury. We need to seek out doctors that specialize in the area and can order MRIs and ultrasounds to identify fascial tears in the perineum, not just the penis. Use descriptors like chronic pain and tightness in the entire area. My guess is the exact problem is in part of the Colles\' fascia near the bulb of the penis (internal base fo the penis). Regardless, an injury anywhere to this fascia will screw up the penis, scrotum, and perineum because it covers all of these areas. There is no way, I repeat no way, any of us will recover without surgical repair of the tear. I have read about one person who has had it for 12 years. Once one of us has success with this the word can be spread. In the meantime, focus on relaxing the perineal area and take supplements like arginine, this will make it a little better for you. I firmly believe normacy can be acheived through locating the problem and surgically fixing it.
Look at these links for threads from other sites and more information about the anatomical structures I have described in this post:
An unresolved case on medhelp of the exact problem we have: rupture of superficial fascia of the perineum - Urology - MedHelp
And again: Perineal Fascia Tear/Rupture - Urology - MedHelp
Medhelp forum thread on the injury: Penis hard even in flaccid state - Men\'s Health - MedHelp
Anatomy:
home.comcast.net/~wnor/perineum.htm
File:Gray403.png - Wikipedia, the free encyclopedia
