OpenHealth Q&A

Struggling with My Urology Visit

Summary: I’ve been experiencing issues related to my genital health and consulted a urologist who simply dismissed my concerns, stating that everything seemed fine. Unfortunately, my condition has deteriorated, leaving me perplexed by the medical documentation I received from him. As a 21-year-old male, standing 180cm tall and weighing 75kg, I noticed a decline in the quality of my erections last year, along with frequent loss of morning erections. Additionally, I observed a lump or dilation on the dorsal vein of my penis, located near the base, which occasionally causes a dull pain. This prompted me to seek an expert opinion from a urologist. Fortunately, I was able to meet with a highly experienced head physician. (As a side note, I have been exploring issues related to hard flaccid syndrome, which the doctor recognized and commented upon.) In his observations, he documented: "There is swelling in the dorsal vein's vicinity, at the base of the penis, close to the pubic symphysis." He performed a Doppler ultrasound on my veins and testicles, ruling out the presence of thrombosis. However, the Doppler was conducted while my penis was flaccid, which leaves me questioning whether any plaque or signs of Peyronie’s disease or penile fibrosis could have been missed because of the state it was in during the examination. The report conveyed: "Both testicular systems are intact, and the anatomy of the penis appears normal. The dorsal vein also shows no signs of thrombosis, and its thickness is consistent throughout. Ultrasound indicates normal blood flow, with both tissues exhibiting homogeneity and adequate perfusion." This is a paraphrase of his findings as translated using ChatGPT. Now, about a year later, my situation has worsened. I’ve started to observe a slight curvature to the left both when flaccid and erect, and I’ve lost about 1cm in length during erections. What concerns me the most is that during erections, the shaft of my penis adopts an hourglass shape; the base and head appear normal, but the center is noticeably narrower, leading to this unusual formation. Although this phenomenon is not painful and tends to resolve itself once fully erect, it remains a source of significant concern for me. I feel quite lost about my next steps, especially since the urologist found no issues and suggested consulting a sexologist if my condition worsened. Would it be advisable to seek out another urologist or to visit a sexologist? I would greatly appreciate any insights or advice regarding how to interpret these results and navigate this troubling situation.

Answers (1)

7/30/2025, 1:50:51 PM

OpenHealth AI

It sounds like you’re navigating a difficult situation regarding your genital health, and it’s understandable to feel concerned given the changes you’ve experienced. Based on your description, it may be worthwhile to seek further evaluation because your symptoms have progressed since your last visit. Here’s a structured breakdown of your situation and next steps:

Main Points:

1. You are experiencing changes in your erections and the shape of your penis, which have worsened over time.
2. Previous tests ruled out certain serious conditions, but your current symptoms suggest further evaluation may be needed.
3. Consider seeking a second opinion from another urologist.

Explanation:

Your report indicates that the initial ultrasound showed no signs of thrombosis, with normal anatomy and blood flow. However, the changes you're now noticing—such as a curvature during erections, loss of length, and the hourglass shape—could suggest a potential condition like Peyronie’s disease, which can develop over time and might not have been evident during the initial exam.

It’s vital to have regular follow-ups, especially if symptoms change or worsen. Since you feel your concerns were dismissed previously, a second opinion from another urologist may provide you with new insights or diagnostic options.

Next Steps:

1. Seek a Second Opinion: Find another urologist, preferably one experienced in male genital health issues. Bring all documentation from your previous visits, as this will help them understand your concerns better.

2. Prepare for Your Visit:

   • Write down all of your symptoms, including how they have changed over time.
   • Note any other related feelings, like anxiety regarding sexual performance, that may impact your well-being.
   • Be ready to discuss specific concerns you have about Peyronie’s disease or other forms of penile fibrosis.

3. Consider a Healthier Lifestyle: While waiting to see another specialist, focus on health-promoting behaviors—adequate sleep, stress management, and a balanced diet can positively impact overall health and sexual function.

4. Emotional Support: If you’re feeling anxious or lost during this process, consider speaking to a therapist or counselor specializing in sexual health. They can provide emotional support and coping strategies.

By taking control of your next steps and seeking a second opinion, you can gain more clarity about your condition and explore potential treatment options. Remember, it’s important to advocate for your health and ensure your concerns are addressed.