A Doctor with Hard Flaccid - Updates and Advice

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Hey dr Romero, thanks thanks for all your precious advice, like many I suffer from Ed. As you know, there seems to be a gap between the communication that impedes our process with URos. I like many, want to thank you for being so transparently dilligeant. Jesus is the best physician, but there are many that have been blessed with healing power, and you sir are one of them!

Hi Mike! We haven't talked in a while...
You're welcome. Thank you very much for the compliment and kind words. That really means a lot to me

My background, as I already mentioned, I had holes like polka dots in my penile sheath. I take 5 MG's of Cialis daily.

Mike, if you feel comfortable, can you tell us the details of the specific accident that caused these holes in the sheath of your penis? If you're not comfortable, don't tell us!! It was just to try to contextualize your injuries a little... But, if you don't want to tell, that's okay
I didn't know that you take cialis daily... And you're taking the maximum dose, for those who take the medicine daily. Was it your urologist who prescribed it?

Lately I have been getting erections and I have been keeping my hands off my penis. My biggest problem is whether I'm applying too much pressure on it in showers or drying. Also I am rattled when I walk every day. It's like a endless battle of what is to be with my penis:
Is it cured, will it sustain, is it gonna break? These are questions I ask myself.

Ok, great! Having spontaneous erections is always a great sign Perhaps, now, you should consider lowering the dose to 2.5mg, then. If you started to have spontaneous erections again and you are avoiding touching the penis, for it to heal, I think you can talk to your doctor to get Cialis down to 2.5mg. To start weaning from Cialis and not addicting your body to it. So that it doesn't lose its effectiveness in the future.

Today I accomplished a lot. But I felt a relapse in the penile pain after getting off the phone then making my way up to my bedroom. What happened is that I was feeling pain so I layed down before it could get any worse. I felt it regenerate

Can you describe that pain a little more, please? In which specific area did you feel the pain? Didn't anything happen that would trigger the pain? In what past situations did you feel this pain?

My question is: will the tunica albuginea heal to a finite limit or else could there be a wound too big to close? (That's my question, ) because am I going around in circles healing and tearing back in forth or is each day bringing forth more hope than the last? (Meaning is it all just a part of the healing phase until it's permanent?)

As I have said many times, the body has a spectacular healing ability. I remind you of the mythical story of John Bobbitt. Whose wife cut off his penis and threw it into the fields. The police only found the penis hours later, the penis was surgically reattached and John entered two pornographic films 3 years later!!
So, the human body is a formidable machine. And if you're having spontaneous erections, that's a great sign

I do not know the true severity of the injury you have on your tunica... But we have already discussed that it is possible that you need surgery to help heal. A few months ago, you told me you were going to talk to your urologist again. And try to discuss with him the possibility of having surgery. Did you call him again or did you go for another appointment?

Someone once told me irresponsibly that 90% of my symptoms are psychosomatic. But that's not the case. It is 100% physical and then maybe 90% mental. The thing is, I have a weak area of my body where the tunica is healing . Couple that with thinking about it all the time puts stress in it leading to it the penis bearing the grunt of damage from over exerting it.

Ok... Yes, you told me a few months ago that you had injured your penis during an accident, correct? Therefore your problem is not psychosomatic.

However, I have also said many times, the management of stress and anxiety is very very important. The healthier our heads are, the faster the body will heal. And note that I am not an apologist for alternative medicine and the like... The influence that the brain has on our physical well-being is really great. A healthy mind is very important in the treatment of any disease. Have you talked to your urologist about this? And with your psychiatrist? What did they say?

I mean that would be nice if my dick healed naturally but I have been dealing with this for 15 years. Haven't been able to mount together a good two weeks in a row. Meaning I just usually lye in bed waiting it out while the perforations heal themselves. But then comes the next day with relapse... Or is it progress?...that is the question.

Please explain this relapse to me. What happens during this relapse? Is it just pain or do other symptoms happen?
I can't be sure, Mike... I never really saw your penis. I've never seen an ultrasound or MRI of your penis. Have you ever had an image exam on your penis? If you already did, do you have the results of the exam on paper? Can you copy the report here or send it to me by private message?

[Mike_b Senior Member Find all posts View Profile Close Mike_b]

U know what Dr Romero, this is gonna sound good but the problem eradicated itself. They told me at first it would take 2 weeks to heal. Then someone told me it would take 3 months to heal. Then a nurse said to me "if you keep reunjuring it it will take longer to heal." Well unfortunately for me it took about 15 and a half years. I can say this with confidence, I kept chipping at it until November 16th. I'm surprising myself, the boners are coming up like they used to. Idk a miracle maybe? The only problem I have now is that I can't take my hands off it because it's working so well I mean it. As of tomorrow I am gonna try cutting out the pharmaceutical s ie Cialis because I don't want to be addicted for 1 other day!

That is half the battle getting off the meds. I know there will be some psychosomatic pain because I just scarred up some thick wounds down there, but I feel 100% and I'm not just saying that. I believe you about that hobbit story. As a matter of fact I feel 110%; I will never doubt the healing powers of the body after this cause like I said I have no symptoms.

The trick now is to get my mind to believe that the pain is just substantial not permanent anymore. Believe me, I think I've kicked this! I have no doubt in my mind that I will return back to a regular sex life. All I have to do is lose some weight and I've got some extra tictacs (Cialis) to take recreationally when I bone! Lol.

Right now my biggest problem other than the world's sad state of covid, is that I have restrictions in my behaviour. These things will get better over time. So yes I am proof that tunicas heal. What I don't do is weights and cardio. I still go for my walks at the park because there is not that much wear and tear, walking outside whereas weights and treadmill is a little bit hard on the body. Like I said I will stop the pharmaceutical dependence part. Once I start trusting in my bodies strength I will start doing the weights and cardio again.

Man I really find it odd we both had similiar journeys with hf, but you have been the wise old ear of the forum. If I ever hear the word Romero in the future it will remind me of a great guy! Anyway there maybe some ups and downs along the way but I feel like I'm part of the human fraternity again, not lower than. The dick is even solid too. I've been waking up with boners laying on my stomach for crying out loud. I really really prayed for this. I told the Lord be a visible help in times of trouble, I already told you about the rest! It's history, but you my friend are just getting started. All that karma you gave to us is gonna come back around and delight you in your medical practice as you will save more lives! I pray that you and your family are safe and that you get thru the covid 19, as well as all the other brothers on this forum. You're a homey to the heart!

Ps I heard of some random rockstar who bragged about fracturing his dick and healing it twice! I imagine he knows alot about the tunica too. I'm just getting started at 37, but it's never been too late. All that matters is the prèsent an eternal now: once again thank you and if I don't complain again don't take it personal lol.

[Mike_b Senior Member Find all posts View Profile Close Mike_b]

You know what I'm keeping all guns blazing here: were just all human beings, we just don't know where to go. We learn these things in time: meds that work, stuff that doesn't work, etc.

I'm just trying to further support that I am not faking a recovery. I may say one second that I may stop taking the meds, but then a minute later I may decide to keep taking them. I see my next professional psych doc on the 25th of November. He once told me there's nothing wrong with having good results with medication. Perhaps I can talk to him about chemical dependence/ addiction, what kind of patterns of behaviour are formulating. He will tell me what to do with or without the meds and with or without what urologist, as I do have several. But the prognosis is good.

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Update -18 weeks after injury:

I am completely healed
I no longer have Hard Flaccid, neither lying down, nor sitting, nor standing, nor walking, nor running, nor training bodybuilding.
And my sex life is wonderful again.

Thank you PEGym, and thank you very much to all of you, who accompanied me on this journey, and who contributed to my learning, as a patient, as a doctor and as a person

And, for all those who are still fighting, please don't give up. Because I wholeheartedly wish to see your "100% healed" posts in the very near future






P.S.: The weeks after injury do not correspond to the date of this post, because I am already healed for a few weeks.

----------------------------------------------------

Mike, thanks for the reply. I'll answer you tomorrow

[RickBhmcsb PEGym HERO Find all posts View Profile Close RickBhmcsb]

Congratulations on your success! That's what I love to read on here! Best of luck to you in the future!

Update -18 weeks after injury:

I am completely healed
I no longer have Hard Flaccid, neither lying down, nor sitting, nor standing, nor walking, nor running, nor training bodybuilding.
And my sex life is wonderful again.

Thank you PEGym, and thank you very much to all of you, who accompanied me on this journey, and who contributed to my learning, as a patient, as a doctor and as a person

And, for all those who are still fighting, please don't give up. Because I wholeheartedly wish to see your "100% healed" posts in the very near future






P.S.: The weeks after injury do not correspond to the date of this post, because I am already healed for a few weeks.

----------------------------------------------------

Mike, thanks for the reply. I'll answer you tomorrow

[HelpmeHF Senior Member Find all posts View Profile Close HelpmeHF]

hello doc,

So i've been unable to do reverse kegels, I can do belly breathing but it honestly doesn't do anything. If I wait this out with no fap, is there a chance this can go away?

I was able to no fap for 3 months and that had some improvement but not a lot to be honest. Unfortunately I broke my no fap streak out of disappointment. My penis when flaccid is HF all the time, pulled to the left and testicles are extremely retracted. This hasn't diminished too much, It definitely gets worse if i force a lot of erections, so it's related to the tightness.

Is it possible the injury has left scar tissue and i'm stuck like this or can this actually go away completely. Would really love to hear your opinion about this. I'm more of a troubleshooter case where erections seem to make things worse. I get strong morning erections and afterwards my HF is pretty bad.

[givemehappiness Junior Member Find all posts View Profile Close givemehappiness]

Update -18 weeks after injury:

I am completely healed
I no longer have Hard Flaccid, neither lying down, nor sitting, nor standing, nor walking, nor running, nor training bodybuilding.
And my sex life is wonderful again.

Thank you PEGym, and thank you very much to all of you, who accompanied me on this journey, and who contributed to my learning, as a patient, as a doctor and as a person

And, for all those who are still fighting, please don't give up. Because I wholeheartedly wish to see your "100% healed" posts in the very near future






P.S.: The weeks after injury do not correspond to the date of this post, because I am already healed for a few weeks.

----------------------------------------------------

Mike, thanks for the reply. I'll answer you tomorrow

Congrats man, nobody should give up on this just like you mentioned.

What do you think excessive precum related to this and penile anomalies?

[HelpMeDoc Junior Member Find all posts View Profile Close HelpMeDoc]

Ok. All of your symptoms point to a strain of the right IC muscle, with a post-injury contracture of the entire pelvic floor.
However, I think it is also possible that you did a slight sprain of the right part of the Suspensory Ligament of the Penis. Not a complete rupture of the ligament. Just a little sprain. Because your complaints of pain and instability are a little more intense than the normal complaints of typical Hard Flaccid cases.

And I think your explanation for your own symptoms is also correct. And the way you are healing it and improving quickly, also supports the diagnosis.
The pain radiated to the Levator Ani muscle is due to the nerve compression of the pudendal nerve, created by the injured right Ischiocavernous muscle.

My advice to you is to keep doing what you've been doing. If you felt improvements in 1 week (as you said on another thread), that’s great! And apply the rest of the advice from my first post on this thread. I updated the treatment list a few days ago

REST. A lot. You have to try to stop masturbation and sex, for the tissues to heal. In addition, if you really have a small ligament sprain, rest is very important. Ligaments take longer to heal than muscles. Rest, rest, rest. And apply all the advice from the first post.
I wish you a continuation of a quick recovery, whatsthestory

Again, sorry for the delay... I will answer everyone, but it will take a while.

Hey Doc - thanks for all you do for this forum.

I have many of the same symptoms as everyone else on here that seemed to crop up after a period of high stress, worrying about PD and "straightening" myself in the shower, and then a "pop" in my groin. You mention in the post above that some people may have injuries to suspensory ligaments - what would be some of the other signs / symptoms of a ligament injury on top of IC injury and would you change about your approach to healing? In addition, reverse kegels don't seem to really give me much relief.

Quick list of symptoms: HF when standing / often when sitting, releases when I pee or when I sit in a bath. "Dent" in the left side of my flaccid penis, penis curves to the left and twist more than previously. Weaker erections, and premature ejaculation when I do have one. Significant swelling above my penis to the left (under pubic hair).

Thanks!

[Millionaire01 Member Find all posts View Profile Close Millionaire01]

Alright Doc thanks for the reply and wow man congrats on your success I hope to have that success in my next 2 - 3 months lol.I will be starting tomorrow with my routine and tracking progress from there.

Im going on full blow hardmode like you said RomeoMD and im going to follow what you told me by doing hindi and belly breaths and continue with stretches I also have am anterior pelvic tilt so I probably have to fix that as well but im sure thats not the cause of my Hard flaccid.

I have some questions for you.
1) what do you think was most important to your recovery like what exercises in particular.
2) how do you heal a IC injury? Or how do you strengthen it?
3)Have you heard of angion method? Apparently it helps heal Hard flaccid.
4) Did the splits help or contribute to your recovery?Are they necessary?
Thanks in advance

[Ginsin Junior Member Find all posts View Profile Close Ginsin]

Hi

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

U know what Dr Romero, this is gonna sound good but the problem eradicated itself. They told me at first it would take 2 weeks to heal. Then someone told me it would take 3 months to heal. Then a nurse said to me "if you keep reunjuring it it will take longer to heal." Well unfortunately for me it took about 15 and a half years. I can say this with confidence, I kept chipping at it until November 16th. I'm surprising myself, the boners are coming up like they used to. Idk a miracle maybe? The only problem I have now is that I can't take my hands off it because it's working so well I mean it. As of tomorrow I am gonna try cutting out the pharmaceutical s ie Cialis because I don't want to be addicted for 1 other day!

That is half the battle getting off the meds. I know there will be some psychosomatic pain because I just scarred up some thick wounds down there, but I feel 100% and I'm not just saying that. I believe you about that hobbit story. As a matter of fact I feel 110%; I will never doubt the healing powers of the body after this cause like I said I have no symptoms.

The trick now is to get my mind to believe that the pain is just substantial not permanent anymore. Believe me, I think I've kicked this! I have no doubt in my mind that I will return back to a regular sex life. All I have to do is lose some weight and I've got some extra tictacs (Cialis) to take recreationally when I bone! Lol.

Right now my biggest problem other than the world's sad state of covid, is that I have restrictions in my behaviour. These things will get better over time. So yes I am proof that tunicas heal. What I don't do is weights and cardio. I still go for my walks at the park because there is not that much wear and tear, walking outside whereas weights and treadmill is a little bit hard on the body. Like I said I will stop the pharmaceutical dependence part. Once I start trusting in my bodies strength I will start doing the weights and cardio again.

Man I really find it odd we both had similiar journeys with hf, but you have been the wise old ear of the forum. If I ever hear the word Romero in the future it will remind me of a great guy! Anyway there maybe some ups and downs along the way but I feel like I'm part of the human fraternity again, not lower than. The dick is even solid too. I've been waking up with boners laying on my stomach for crying out loud. I really really prayed for this. I told the Lord be a visible help in times of trouble, I already told you about the rest! It's history, but you my friend are just getting started. All that karma you gave to us is gonna come back around and delight you in your medical practice as you will save more lives! I pray that you and your family are safe and that you get thru the covid 19, as well as all the other brothers on this forum. You're a homey to the heart!

Ps I heard of some random rockstar who bragged about fracturing his dick and healing it twice! I imagine he knows alot about the tunica too. I'm just getting started at 37, but it's never been too late. All that matters is the prèsent an eternal now: once again thank you and if I don't complain again don't take it personal lol.

You know what I'm keeping all guns blazing here: were just all human beings, we just don't know where to go. We learn these things in time: meds that work, stuff that doesn't work, etc.

I'm just trying to further support that I am not faking a recovery. I may say one second that I may stop taking the meds, but then a minute later I may decide to keep taking them. I see my next professional psych doc on the 25th of November. He once told me there's nothing wrong with having good results with medication. Perhaps I can talk to him about chemical dependence/ addiction, what kind of patterns of behaviour are formulating. He will tell me what to do with or without the meds and with or without what urologist, as I do have several. But the prognosis is good.

Mike, I am very, very happy for you, my friend
Thankfully, everything is starting to return to normal

But now, don't abuse your penis! xD Don't masturbate 10 times a day! Try to restart sexual activity in a healthy, progressive, smooth, non-aggressive way.

And starting to go to the park every day and exercising are great ideas.
I'm glad you're finally smiling

And, yes, you should always talk to your doctors about the decisions they make that concern you.

Thank you very much for the kind words You are a beautiful person, too. Your life force and the way you motivate others are admirable.
Congratulations on your success, Mike. A brotherly hug for you.
Be happy

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Congratulations on your success! That's what I love to read on here! Best of luck to you in the future!

Thank you very much Rick! For you too

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

hello doc. So i've been unable to do reverse kegels, I can do belly breathing but it honestly doesn't do anything.

Hi HelpmeHF

Have you been reading the latest posts, from members who are also struggling to do Reverse Kegels? Have you tried to combine Belly Breaths + Hindi Squats + RKs? Don't you feel your pelvic floor expanding more when you combine the 3? Don't you feel like peeing and the anus opening? It's this feeling that you have to look for. That is a Reverse Kegel.

If I wait this out with no fap, is there a chance this can go away? I was able to no fap for 3 months and that had some improvement but not a lot to be honest. Unfortunately I broke my no fap streak out of disappointment. My penis when flaccid is HF all the time, pulled to the left and testicles are extremely retracted.

I think NoFap is important. Because it gives your muscles a break. I don't think I would ever have healed so quickly if I hadn't been sexually abstinent for almost 3 months. For me, NoFap is very important to treat Hard Flaccid. But you have to combine it with the rest of the exercises and items on the list, to be efficient.

This hasn't diminished too much, It definitely gets worse if i force a lot of erections, so it's related to the tightness.

You already know that forcing erections is a bad idea... You are putting too much tension on your muscles when you do that. And then you go back to square one. I really enjoy having spontaneous erections, but, if you don't have them yet, forcing erections is counterproductive.

Is it possible the injury has left scar tissue and i'm stuck like this or can this actually go away completely. Would really love to hear your opinion about this. I'm more of a troubleshooter case where erections seem to make things worse. I get strong morning erections and afterwards my HF is pretty bad.

I truly believe that it is impossible for Hard Flaccid to create scar tissue.
If it can go away completely? I will quote the answer I gave you 3 weeks ago:
“Do I think it is permanent? No. Don't even think about it. Forget it. It is not permanent at all. You just need to be aggressive and constant in relaxing your muscles in the opposite direction. Don't you know people who have had muscle injuries for several months/years, and who are able to fully recover, with physical therapy, time, rest and good nutrition? It is exactly the same here. There are milder injuries and more serious injuries. And the rate at which each body recovers depends on many factors. But what really matters is that the body is a healing machine. You just need to offer it the right materials and stimuli.”

Have you ever had an image exam on your penis? Why don't you make an appointment with a Urologist and ask for an ultrasound or an MRI scan? So that you can be more mentally rested. It helps. It decreases stress. But I think the Hard Flaccid is completely reversible.

Regarding erections, it seems that Troubleshooter has already found a way to solve the problem. Ask him what the secret is Troubleshooter, come here, please. Give us a hand

Lastly. How is your posture, physical activity, flexibility and posterior chain strength? I updated the first post with some information regarding this. It's all on the list. There are some chronic patients who are improving faster after investing more on correcting posture and Anterior Pelvic Tilt.

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Congrats man, nobody should give up on this just like you mentioned.

What do you think excessive precum related to this and penile anomalies?

Hi Givemehappiness! Thank you

Excessive precum?... I think you're the first person to ask me that... Are you having more precum since you have Hard Flaccid? In what situations? Associated or not with sexual activity? Are you doing NoFap? I am not finding a concrete explanation for that association. And I think I have never read any patient with that symptom. Did you read that association somewhere? If so, send me the article, please.

What penile anomalies? Bends, twists, cords, bumps, ribs and ridges?... I have already explained why those happens. Please read posts 141 and 183.

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Hey Doc - thanks for all you do for this forum.

Hi HelpMeDoc! Welcome to PEGym Interesting name...
You're welcome

I have many of the same symptoms as everyone else on here that seemed to crop up after a period of high stress, worrying about PD and "straightening" myself in the shower, and then a "pop" in my groin. You mention in the post above that some people may have injuries to suspensory ligaments - what would be some of the other signs / symptoms of a ligament injury on top of IC injury and would you change about your approach to healing?

Sprain/Tear of the Suspensory Ligament of the Penis:

Causes:
- Stretching/Hanging too intensely and without conditioning (too much, too soon).
- Put the erect penis too downward (or too sideways), during masturbation, sex (Ex: reverse cowgirl), falls or accidents. Depending on the flexibility of each person.

Symptoms:
- You may hear a small cracking or popping sound at the base of the penis, at the time the sprain happens.
- Pain. Around the base of the penis. It is the most frequent symptom. It ranges from minimal to severe. It can be sharp and intense at the beginning of the injury and in serious injuries. Sore/dull pain/burning pain in minor injuries. It can radiate to the groin, to the inside of the pubis, to the lower abdominal region and, sometimes, to the pelvic floor. The pain is more intense the bigger the ligament sprain. The tear of the ligament is very painful.
- Sensation of instability and detachment of the base of the penis, mostly in the place where the ligament sprain occurred.
- Erection does not stand upright. Lower erection angle. Penis seems to hang lower from the body.
- Presence of a palpable gap between the pubic symphysis and the penis.
- Possible erectile dysfunction.
- Bruising, discoloration and swelling at the injury site.
- Possible bending or twisting of the entire shaft of the penis.
- During healing, adhesions, calcium deposits and scar tissue can form at the tear site, causing lumps or bumps.

Treatment:
- Lots and lots of rest. Sleep a lot. No PE, no sex, no masturbation, no erection tests, nothing. At least 4 weeks. Ligaments take a long time to heal. The rest has to be longer, when the sprain is more severe. That is, it can last up to 3-6 months. Masturbation, sex or PE, while the ligament is not healed, is totally contraindicated. It can cause an even greater sprain/tear of the ligament.
- Cold therapy. Apply ice, only for the first 72-96 hours. For 20 min, several times a day. Cold promotes vasoconstriction. It helps to close blood vessels more quickly and decreases bleeding, bruising and swelling. However, it is anti-inflammatory and reduces healing, because it decreases the blood flow of nutrients and oxygen to the tissues. Therefore, ice ceases to have advantages after the first 3-4 days.
- Heat therapy. Apply heat compresses. After the first 72-96 hours and until the end of the healing process. Many times a day. As opposed to cold, heat promotes vasodilation. It increases the blood flow of nutrients and oxygen. Helps in healing. However, it is contraindicated in the first 72-96 hours because it will increase swelling and bruising.
- Extraordinarily healthy diet
- Supplements: L-Arginine, Arnica, Whey Protein, Vitamins A, Bs, C, D and E, Fish Oils, Glucosamine, Chondroitin, Bromelain, Curcumin, Gelatin, Taurine, Magnesium and Zinc
- Very, very light massages. After 72-96 hours. To stimulate the tissues a little. Rehabilitation. It has the same effect as heat.
- Tighter underwear (different from Hard Flaccid), to help healing. Try to put your penis in a neutral (upward) position inside the boxers.
- Reattachment surgery. In the most severe cases or complete tear - Repair of the penile suspensory ligament for congenital and acquired pathology
- Anti-inflammatory drugs slow down the healing process. They are only indicated if you really have a lot of pain.

Important:
- Go to the hospital immediately if you think the injury is serious: if you have a lot of pain, a big bruise, a big swelling, etc.

Quick list of symptoms: HF when standing / often when sitting, releases when I pee or when I sit in a bath. "Dent" in the left side of my flaccid penis, penis curves to the left and twist more than previously. Weaker erections, and premature ejaculation when I do have one. Significant swelling above my penis to the left (under pubic hair).

Ok. Everything typical. Your Hard Flaccid case is the same as mine.
Except, that swelling on the left side… Do you have pain in that area? How long ago was your injury that caused Hard Flaccid? If you also have pain, it is possible that you have a slight ligament sprain, yes.

In addition, reverse kegels don't seem to really give me much relief.

My treatment list has more than 20 items. Are you applying them all? Didn't you feel any improvement with any of them? It is not just Reverse Kegels that are important.