[richardc]

I come to you as someone who is in desperate need of some advice. I am having erectile difficulties that have been caused by psycogenic and I now suspect physical factors. I have seen several urologists who have told me they can not tell me the reason for my problems. I had a doppler ultrasound under prostglandin e1 that came back normal.

The key symptoms are that i am experiencing firmness in the shaft whilst flaccid; that the glans of my penis is quite soft (Even a little `mushy`) during erections; i lose my erection without direct manual stimulation; and will lose an erection almost instantaneosly when standing up. These symptoms occured from about a month ago, when I masturbated quite forcefully under the influence of ecstasy and marijuana. Since then, I noticed immediately the firmness in the flaccid shaft.

I am hoping you can help make a diagnosis as I have read hundreds of forum and articles and when it comes to these questions, experts usually say they can`t answer. The only thing I can think of that could have possibly caused this is a priapism. However, I have never recalled having a 4-6 hour rock hard painful erection, although I had a series of semi-rigid erections that lasted a couple of hours immediately after the ecstasy event.

In fact my symptoms are near identical to one of forum member, I happened to read. The expert could not respond. I am hoping you can and have listed his case below

Starting about 3 years ago, my erections became less firm. This phenomenon occured during a 1-yearish episode of depression which I immediately linked to this symptom. It is now 3 years later, however, and I am not depressed at all anymore and I have not been for about 2.5 years. The problem has continued and even gotten worse. I do not often experience morning erections. They do occur occasionally, but quite infrequently. Whereas I used to get spontaneous erections and be able to achieve erection just by visual stimuli, this is no longer the case. I almost always need direct stimulation for a chance to achieve erection. When I masturbate, I almost always achieve erection and maintain it with continued stimulation. However, the glans often does not become hard although the shaft is. If I discontinue stimulation, the erection disappears quite quickly. Often, if I stand up, even with continued stimulation, the erection disappears. During intercourse, there are rare times when I can maintain an erection for a longer period of time (15-30 minutes). But as said, these times are rare. Sometimes (about 1 time out of every 5 sessions) I lose my erection during intercourse. Sometimes I am able to get it back. I am not experiencing performance anxiety and I have spoken with my partner about the problem. I do not think that any (conscious) psychological difficulty is affecting this. The soft glans during erection as well as the quick drainage after the cessation of stimulation (and standing up) leads me to suspect the problem might be related to venous leakage. However, does this theory clash with the occasional secure erection? What do you think the likely cause of this is? I have done all the reading on drugs, etc. What treatment options are available, if any, that are more permanent? Thank you very much.

[UroDoc]

Doesn't sound like Peyronies. You might try Viagra, Levitra, or Cialis to see if it gets you back on track. Good luck.

[richardc]

Dear Doctor,

I have tried those tablets, and they used to work quite well. However, after the incident, they dont work very well at all. My penis will rapidly detumesce in the absence of physical stimulation. Was wandering if you can tell me
1. Why it is erections seem to collapse on standing up (they can not point up). Doctors tell me its because I'm being anxious. Could it be due to a venous leak?
2. Also, suppose that my penis responds to intracavernous injection, is this evidence that there is NO tissue damage? (logic = if penile tissues can be thoroughly engorged, then the fact that there is no erection means its a psychological problem)

[tibye28]

Dear Doctor,

I have tried those tablets, and they used to work quite well. However, after the incident, they dont work very well at all. My penis will rapidly detumesce in the absence of physical stimulation. Was wandering if you can tell me
1. Why it is erections seem to collapse on standing up (they can not point up). Doctors tell me its because I'm being anxious. Could it be due to a venous leak?
2. Also, suppose that my penis responds to intracavernous injection, is this evidence that there is NO tissue damage? (logic = if penile tissues can be thoroughly engorged, then the fact that there is no erection means its a psychological problem)