22 Year Old with Severe Impotence from Improper PE. any advice

I have to have missed this passage; was actually that diagnosed by a doctor?

I have not posted on TP in eons; work, illness, divorce, new relationship…life gets in the way sometimes. I pass by and read and enjoy the posts of many whom I posted discussions with in the past. But mikey88 your post and the suggestions by others, particularly many moderators, interested me to make comments.

First as a preface it must be understood that even though I am a doctor, I don’t play one on this site. Though I am not a urologist (being on the “stream team” was not of interest to me), I do know enough about surgery, general medicine and normal human physiology to make reasoned and knowledgeable comments. Second, any clinician (physician, psychologist…) who makes diagnoses on the internet without first seeing and truly understanding a patient is, in my mind, at the least less than professional and at worst a charlatan. I never do this and please do not request it. So as I said, I will make comments; any recommendations I would make would be to consult your own doctor or a specialist. That said I proceed…

It is far from it mikey88…and that says a lot. You are anxious. All of us on this site with sexual experience, particularly of a negative nature are. So by saying you are anxious is not saying you are “mental” – to use your words. (In my mind it is an adjective, not an accusative noun). It is a very imprecise and derogatory term and you must strike it from your mental image (see it’s an adjective here) now if you are to make any progress.

Let’s unpack your presentation. First you are young and I would say naïve. That is also not derogatory. Your initial approach to blindly forge into PE without some knowledge, though not uncommon, demonstrates this (and they are naïve also). That is what this forum was established for and continues to be an outstanding resource for just about everything penis. Being young and naïve is not a crime (oh how I wish I was again), however having a limited period of life experiences shades your expectations. You mention that it worked before, but now it doesn’t do it like it normally did, there must be something wrong (to paraphrase). Any man who says that everything about the function of their penis and/or their erections is always the same is either a liar or is smoking something I want. So when something is different when you are young and naïve, it is a big deal and you stand up and take notice, even if the part of your body you are worried about is not.

If you search penis curve on this site you will find many threads about it, some with the anatomy and science about it and others of how to “fix” it. It is very common. If you got it, you’re human (just like me)…

Your approach to hanging was again with little knowledge. Mixing sexual stimulation and /or hanging an erect penis is in my mind a no-no, particularly when there is pain involved. I hope that you have heard that if it hurts, don’t do it. Well that is (at least) doubly true about your penis. Think about it. You start to arouse or you hang weights on an erection and you feel pain (extremely painful to use your words)…hmmmm…your start to worry about setting up an aversion reaction – that is, erection = pain. You may say, Pud, an aversion reaction is a behavior and I would say that an erection is a behavioral response to a stimulus (albeit a physiological one). Associate that with pain and you can cause some problems.

Now add that to the numerous experienced “failures” that you describe. All of us have had experiences where our penis just gets embarrassed and doesn’t work just right and we get embarrassed. And when our partner says that “…I never fucked hard enough…”, whoooa…now that hurts. For the rest of us that sets up performance anxiety as marinera rightly suggested. Unless you are from another planet, you are no different…

And anxiety in general…

I think that constitutes high anxiety. Mikey88, you have to recognize and admit that. All of this is affecting you. You are on a PE site. All of us here are focus on our penis and there is nothing wrong with that (though Freud would probably have had something to say about our mother or when we were potty trained, that’s in another thread…). When your entire life and existence revolves around your penis and its function or its lack of “normal” function, you are peno-centric (penis centered) and that is not good.

About your doctors. They listen and examine and then make diagnoses on what they hear and see. Do they have biases or preconceived notions? Yes, particularly when you start mentioning PE to most urologists. Looking at your picture, I have to say I see little wrong, but more about that later. You had one doctor order up penile Doppler on you. It is considered the “gold standard” for studying men with ED. This however is not always true, particularly young men:

Let’s think about it. You’re nervous., Your catecholamines (adrenaline/noradrenaline or epinephrine/norepinephrine) are already skyrocketing because your nervous that your penis is not working like you believe it should. And now you’re exposing yourself and they’re sticking your penis with PGE-1 (and hopefully with but not always phentolamine). Do you think that your response will decrease? Ahhh…I don’t think so. Catecholamines are potent smooth muscle contractors. Nothing will take the starch out of your erection like being scared and raising your adrenaline/noradrenaline levels. This is why penile Doppler’s are unreliable in your age group and your urologist should have known this and counseled you. That he did not speaks loudly (and that is all I will say about him). And then as you say he said

Again, any “doctor” who diagnosis you without knowing or evaluating the entire picture with complete data should be suspect. That label is premature (or self-diagnosed)

Now you enter the world of what marinera rightly called self-diagnosis and even setting therapeutic interventions:

My God man, you are not even sure what you have and you’re set to perform radical surgery on the only penis you will ever have????

You have had comments by a number of trusted moderators about your symptoms and signs and I agree with their approach. BTW, I believe you mean to say keratinized not dekaratinized because from your pictures you are not dekaratinized.

Again I will say that your pictures are unremarkable. Many of us have experienced less than complete glans erections; search the posts. A circumferential superficial vein behind the glans is not unusual. The change in caliber of superficial vein is dependent on a number of factors (most normal), injury in the past is only one (abnormal). Feeling of temperature of your penis and testicles vary and is a subjective “measurement”, at best. We all drip in our pants on occasion, even when we are young, oh well…

You are hyper vigilant about anything penis; for good reason, you are worried.

Mikey88, listen carefully to what you said:

You describe very high anxiety…

Now listen carefully to what I say. This is not a diagnosis, just a suggestion…

Nowhere in what I have read from what you wrote have you said that you have talked with a psychologist or any other mental health-care professional. You describe having suicidal ideations. That is not good. Unless I am wrong, your stint on anti-depressants was like the tadalafil; self medicating. You describe trauma both physical and emotional (from your girlfriends words and subsequent performance issues). These set up emotional and behavioral roadblocks that can require help. It is not an admission of mental instability to request help. I have and I’ll bet numerous others of us will admit the same. Even if (or especially if) you go to an “expert” urologist who recommends you do any of the radical procedures you suggests that your research leads you to believe you need, you first need to seek out a mental health professional, particularly one experienced in sexual trauma, to talk about this and see if he (or she ) can help first…

Only a suggestion. Be well man, I wish you luck…

Nice to read you again Pudendum :) .

No no doctor “diagnosed” me of having a blockage or leak, just stated it was possible and seems likely when I asked

@pudendum

$$:I know I am anxious, I believe anyone in my shoes would be.

Let’s unpack your presentation. First you are young and I would say naïve. That is also not derogatory. Your initial approach to blindly forge into PE without some knowledge, though not uncommon, demonstrates this (and they are naïve also). That is what this forum was established for and continues to be an outstanding resource for just about everything penis. Being young and naïve is not a crime (oh how I wish I was again), however having a limited period of life experiences shades your expectations. You mention that it worked before, but now it doesn’t do it like it normally did, there must be something wrong (to paraphrase). Any man who says that everything about the function of their penis and/or their erections is always the same is either a liar or is smoking something I want. So when something is different when you are young and naïve, it is a big deal and you stand up and take notice, even if the part of your body you are worried about is not.

$$: I Blindly attempted PE because on the site I was receiving information from there was very little warnings if any at the time.

If you search penis curve on this site you will find many threads about it, some with the anatomy and science about it and others of how to “fix” it. It is very common. If you got it, you’re human (just like me)…

Your approach to hanging was again with little knowledge. Mixing sexual stimulation and /or hanging an erect penis is in my mind a no-no, particularly when there is pain involved. I hope that you have heard that if it hurts, don’t do it. Well that is (at least) doubly true about your penis. Think about it. You start to arouse or you hang weights on an erection and you feel pain (extremely painful to use your words)…hmmmm…your start to worry about setting up an aversion reaction – that is, erection = pain. You may say, Pud, an aversion reaction is a behavior and I would say that an erection is a behavioral response to a stimulus (albeit a physiological one). Associate that with pain and you can cause some problems.

$$: Very True. I didnt know what possessed my mind at the time to even do what i did.. and at 17.5 I had a very high pain tolerance and sort of feel like your invincible, however this is very untrue. I understand I made serious mistake, however I cannot go back in time at this point. So mourning about the mistake does not help the situation at all..

Now add that to the numerous experienced “failures” that you describe. All of us have had experiences where our penis just gets embarrassed and doesn’t work just right and we get embarrassed. And when our partner says that “…I never fucked hard enough…”, whoooa…now that hurts. For the rest of us that sets up performance anxiety as marinera rightly suggested. Unless you are from another planet, you are no different…

And anxiety in general…
Originally Posted by mikey88

I went 20 days without sleep and was suicidal twice.

I think that constitutes high anxiety. Mikey88, you have to recognize and admit that. All of this is affecting you. You are on a PE site. All of us here are focus on our penis and there is nothing wrong with that (though Freud would probably have had something to say about our mother or when we were potty trained, that’s in another thread…). When your entire life and existence revolves around your penis and its function or its lack of “normal” function, you are peno-centric (penis centered) and that is not good.

About your doctors. They listen and examine and then make diagnoses on what they hear and see. Do they have biases or preconceived notions? Yes, particularly when you start mentioning PE to most urologists. Looking at your picture, I have to say I see little wrong, but more about that later. You had one doctor order up penile Doppler on you. It is considered the “gold standard” for studying men with ED. This however is not always true, particularly young men:
Quote

“Low PSV [peak systolic velocities] measurements in young men (less than 30 years old) with ED should be interpreted with caution. The effect of sympathetic overtone because of the environment in the office and anxiety related to penile injection, together with any underlying psychological disturbance, should be taken into consideration during the evaluation of the results of the CDU [color Doppler ultrasound]. Repetition of the CDU is recommended before considering any additional invasive diagnostic or therapeutic modalities.” Shamloul R. Peak systolic velocities may be falsely low in young patients with erectile dysfunction. J Sex Med 2006 Jan;3(1):138-43

$$: Very True I realize that anxiety and environment of the situation can make a Doppler test invalid…

Let’s think about it. You’re nervous., Your catecholamines (adrenaline/noradrenaline or epinephrine/norepinephrine) are already skyrocketing because your nervous that your penis is not working like you believe it should. And now you’re exposing yourself and they’re sticking your penis with PGE-1 (and hopefully with but not always phentolamine). Do you think that your response will decrease? Ahhh…I don’t think so. Catecholamines are potent smooth muscle contractors. Nothing will take the starch out of your erection like being scared and raising your adrenaline/noradrenaline levels. This is why penile Doppler’s are unreliable in your age group and your urologist should have known this and counseled you. That he did not speaks loudly (and that is all I will say about him). And then as you say he said
Originally Posted by mikey88

The last doctor I seen told me my anxiety may be contributing to my ed but it is Physical Organic Impotence.

Again, any “doctor” who diagnosis you without knowing or evaluating the entire picture with complete data should be suspect. That label is premature (or self-diagnosed).

$$: True I honestly Don’t know what my main causes is yet and neither does/did he. I will have to have a DICC done to see if I have venous leaks or possibly blockage.

Now you enter the world of what marinera rightly called self-diagnosis and even setting therapeutic interventions:
Originally Posted by mikey88

I have came to conclusion I have a “venous leak” possibly multiple and possibly even ruptured or blocked an artery.

I have contacted some well known doctors who perform venous stripping, ligation, and embolization and am waiting to hear back from them. I consider risky surgery as a last resort. Currently if I can have a DICC performed and have only a few easy accessible leaks I will consider it an option.

I have done extensive research on venous embolization, stripping, re-vascular surgery for supply arteries.

My God man, you are not even sure what you have and you’re set to perform radical surgery on the only penis you will ever have????

$$: No not necessary, i see surgery as a last resort, but my penis is not working properly by any means currently and it has not been for 3-4 years which makes me thinkg that if it was going to heal it would have already… The way that I was hanging weights seems like it would be prone to cause venous leaks or ruptures due to the nature of the high internal pressures built up. One user on here Yataghan50 was suffering similar symptoms and have venous embolization done and his penis/glans has been working for 6 years post surgery. I am also not sure If I may have ripped or sprained my suspensory ligaments..

You have had comments by a number of trusted moderators about your symptoms and signs and I agree with their approach. BTW, I believe you mean to say keratinized not dekaratinized because from your pictures you are not dekaratinized.

$$:Correct my glans is Keratinized. It looks like the sahara desert.. I typed the original story late one night and got them mixed up.

Again I will say that your pictures are unremarkable. Many of us have experienced less than complete glans erections; search the posts. A circumferential superficial vein behind the glans is not unusual. The change in caliber of superficial vein is dependent on a number of factors (most normal), injury in the past is only one (abnormal). Feeling of temperature of your penis and testicles vary and is a subjective “measurement”, at best. We all drip in our pants on occasion, even when we are young, oh well…

You are hyper vigilant about anything penis; for good reason, you are worried.

Mikey88, listen carefully to what you said:
Originally Posted by mikey88

I have realized that my sex life will never be the same not even a 20th of what it was pre-trauma. I know this sounds pessimistic and negative but its the truth.

You describe very high anxiety…

Now listen carefully to what I say. This is not a diagnosis, just a suggestion…

Nowhere in what I have read from what you wrote have you said that you have talked with a psychologist or any other mental health-care professional. You describe having suicidal ideations. That is not good. Unless I am wrong, your stint on anti-depressants was like the tadalafil; self medicating. You describe trauma both physical and emotional (from your girlfriends words and subsequent performance issues). These set up emotional and behavioral roadblocks that can require help. It is not an admission of mental instability to request help. I have and I’ll bet numerous others of us will admit the same. Even if (or especially if) you go to an “expert” urologist who recommends you do any of the radical procedures you suggests that your research leads you to believe you need, you first need to seek out a mental health professional, particularly one experienced in sexual trauma, to talk about this and see if he (or she ) can help first…

$$: I have seeked two psychologists, both of whom were no help i walked out of their offices feeling 10x worse than walking in, I believe this is mainly because never have they had a patient that told them their dick does not work anymore. They seemed really shocked and offered no help nor gave me any compliments about me at all…I could have received better treatment by talking to a pet dog or squirrel.. I have been trying to get a hold of a well known sexual therapist, who the last doctor i saw recommended. physiological, but i have left 6 messages on her answering machine and she never called me back yet.. I will try calling her again tomorrow. True I need to talk to one experienced in sexual trauma..

$$: As far as the “roadblocks” I have failed sexually twice in the past three weeks. Even though I failed still say i had large balls to go over the mental hurdle. My erections are very week and whenever i move around they just die, also my soft glans makes it hard to initially “get it in” after a few penetrations it just goes soft. This was experimenting with 15mg of cialis also.. The other time i couldn’t even get 80% erect so i gave up, without cialis…

Only a suggestion. Be well man, I wish you luck…

Are you able to kegel?

Did you ever kegel while hanging?

When you ejaculate can you feel the muscles at work?

I believe I can still Kegel. I still don’t quite understand what it is full yet.

I might have involuntary kegeled while hanging…I cante remember specifically.

If I ejaculate yes I can feel my whole penis pulsate and contract but it not pleasurable feeling at..Also my load just drips out it no longer shoots…

Thank you! I was trying to find a polite way of pointing out that we have a number of medical professionals here, non of whom are rushing to give a dex.

mikey88, I have spent time in Behavior Control Units. I have suffered a twisted nut from playing sports and feared Gang Green combining with the loss of my testicles (12 years old). An ultrasound on the sack is something I won’t forget.

I know at my young age which is quite about yours (There is nothing wrong with pointing out this). That when you open up first time doors, everything is unknown. It seems paradoxical to me, from joining Thunders’ Place.
That we hear about certain factors of your life, that bring you down, giving us only the opportunity to respond, in a way that flips the frown. :) It seems unorthodox as well, for a new comer to not share in some positives, I’d ask but that’s certainly not policy. I’d rather hear what prophecy you have, that develops pride. ( As one would say, a new thread perhaps? Lose your Thundersplace posting virginity here! )

My suggestion to you on your situation: Video Camera, film yourself sleeping. Seems kinda weird but its contents of privacy, are entirely yours. What are you looking for? Knowledge of if, and when ( date \ hour of time. I suggest 24 hour clocking. ) you can see nocturnal erections. That is good, I believe the assumption of this would be that your penis functionality is 100% on par with the entire human race. Even further to wet dreams, your dick is in perfection as well as the brain. If the links in thought in front of neurons, are firing dreams, you know harmony between brain and body, is tight on the seams. With that visual proof, the working parts of the penis are all in good order.

When I was at the hospital I had people watching me sleep. In jail they circle and spot you, every 10 minutes like hawks (yup my dumb ass been there too) Life can get pretty shitty sometimes, but mentality is heaven and hell. You can never judge a book by its cover, until you get in, to know it is well.

I do have a lot going for me and things i take pride in but i rather not give away my identity.
It is impossible for me to tape myself in the dark and i do not have camera that tapes for more than an hour. I have been taking 5mg daily cialis and it is helping with my nocturnal, morning, and random erections but they are still very weak and soft. Not Rigid.. I cant even feel i have one besides it hitting my leg or pulling on my jeans.. Its like I’m trying to put air in a tire but i have a leak or hole somewhere that never allows it to lock out and maintain the pressure. I am certain i have not had a wet dream in 4-5 years…

Thanks for reply

Just an update I did have a semi morning g wood the other day with no vitamins of tadalafil which was unusual..still weak though… my penis is still super tiny , numb and dead in flaccid state…I am planning on leaving alone for a week… it may be more of an artery supply issue more so than leakage although I believe I have both.. still no replies from any doctors …

The Tadalafil is definitely helping my morning erections but still there only abut 70%. Also i get 1 or two random chubbies during the day with it still only about 50% but last quite a while.
I have been trying to figure out what exactly is wrong with my glans….
1. It is Extremely Kerantized from the Vacuum device I used.
2. I have a 1/2 hard as a rock piece of what feels like scar tissue directly on the top lining of what i believe is my urethra…. This could possibly why my glans doesnt inflate fully because it is limiting the amount that the glans can expand because the scar tissue or what ever it is prevents it from relaxing and expanding.. This could also explain why my Penis still have sever cracks and dry spots even when erect! Just a thought…

Ive had a few people PM me and I have two sets of scarring/tissue: one on my shaft and one on my glans. I sort of have 3 D sketches of their location and will try to upload them soon..
Heres a few pics of my:
Flaccid appearance (note how large the gap is between my pelvis)
A Pic 15% erect and the bottlenecking that occurs if i am getting excited at the exact location I have the scar tissue in my shaft (Very deep and internal tissue)
And also my extremely kerantized glans.

Any suggestions would be appreciated

I don’t know if anyone has mentioned before, it seems like you are very depressed about your package. It is totally understandable. Have you tried to focus on other parts of your life for the time being. Maybe you are putting too much pressure on yourself. What do you do for fun (beside sex)? Any short term reachable goals in your life, such as school or work? Try not to focus too hard on your package. It will recover. The more you pressure yourself, the worse it will get.

Nothing wrong with it veins or blood vessels are normal, even when you do not have a erection .

I have not gotten a full erection in over 2 year and 6 months. Most of time it’s about 70% to 80%. I had this issue for about 11 years. 24 by the way

Hey Mikey!

I am responding here to your PM. I have read through the whole thread. Listen carefully. Pudendem is probably the most professional and trained member I know of here (there may be others, but I am unaware of them), and is an actual MD with great interest in PE, so is pretty knowledgeable about the subject.

You problem is beyond the scope of what anyone here can do to help you other than advise you to keep searching for the appropriate professionals to help you. As Pudendum said, anyone that attempts to diagnose you without a physical examine is just guessing, and you are well beyond the point where guessing is going to be helpful.

If I was to guess, it sounds to me like you have something physical going on, but the psychological part is increasing the symptoms. This is perfectly understandable, any of us would be scared in your place and that fear alone can render a man completely impotent.

From reading your symptoms, I am encouraged that you have good partial function, and I don’t think you are in as bad shape as you fear, I think its the fear that is making all the symptoms appear much worse.

Anyway, in my opinion, you need to continue to search for the proper professionals to help you through this and hopefully get PROPER treatment. I also agree with Pudendum that you MUST ADDRESS THE PSYCHOLOGICAL ISSUES as soon as possible. If you let yourself spiral down into a suicidal depression, then you are placing your life at risk and will not get the chance to solve this issue, and I truly believe you will come out of this in pretty good shape to have a good life…once you find the right professionals to help you.

Going without sleep for days on end can lead you into a mental breakdown, where all hope seems to be lost and desperate acts seem the answer. A few good nites sleep would give you a vastly better outlook, so you can’t let yourself slide so deeply into this depression.

I would concentrate on finding a good mental health professional, as Pudendum suggested first. This will allow you to then find a qualified Urologist much more effectively when you aren’t so anxious and reactive, and it will help give you the perspective that you life is NOT ruined and there is hope to resolve this situation.

So my advice to you, and I hope you take it, is to first find a good Mental Health professional, and as Pudendum suggested one who specializes in sexual trauma, and then when you are sleeping properly and feeling a bit better, continue the search for a Urologist that is competent in helping with this problem.

Like I said, the problem appears far from hopeless to me, so chin up and don’t think its all over for you, its not.

Good luck.