Hi, Well if your power of will to find a solution then with personalized therapeutic plan under close medical monitoring you should be able to overcome the issue. This won t be easy. This requires long detailed therapeutic plan to help. I will gladly give a short glimpse of such a plan. Feel free to contact me for detailed plan and step-by-step action. First, your first goal would be to lose weight. It is easier said than done. This can be done using caloric deficit, that will result in weight reduction without suffering. Second, you need to include daily exercise. I know this will be hard due to the stenosis. At start this could be simple gradual exercise plan. In a period of 1-3 months you will start noticing difference. During this period, If I were your treating physician I would prescribe you Metformin, medications that can help you will premature ejaculations. I would monitor your testosterone levels closely too. Prescribe supplements if needed. From what I read, It is great that the stenosis pain responded to physiotherapy. With aforementioned therapeutic intervention you will not only add years to your life but also quality to your life. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Ahmad Nazzal