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Suggest treatment for prolonged painless erection

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Urologist
Practicing since : 2002
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I have been suffering from prolonged painless erection almost 2 years now. Gradually the erection time and hardness increased. Last one year I get erection every night that lasts hours until I get up. Urination or simply standing for few minutes softens it most often. Regardless how many times I had intercourse/masturbation before sleeping, I get same erection and hardness that I never used to get before this problem has started. The erection is always non-sexual, no associated urge for sex. I am gradually losing penile sensation and pleasure during ejaculation. Now, sometimes I cannot tell if the penis is erected without touching it. Erection is more likely when I am in the bed, sleeping or simply lying. Only medicine I take regularly is Lipitor for cholesterol.

I am diagnosed with cervical stenosis and spondilosys in C4-5, C5-6 and C6-7 levels, almost the same time this problem first began. I have mild neck pain and occasionally I get numbness or tingling in my hands and fingers during sleep. Took physical therapy for that, the problem is moderate.

I also have long standing problem with weak stream of urination and voiding bladder. My normal residual volume is 165 cc. I am diagnosed with bladder neck stricture but the doctor deferred surgery due to side effect of retrograde ejaculation. I have been living with this condition 20 years now. I urinate frequently, that's the only problem I face so far.
I visited both urologist and orthopedic specialists for this prolonged erection problem. The orthopedic surgeons, and urologists ruled out this being caused by any spinal cord problem. I have MRI of whole spine.
The urologists I visited ruled out that this being caused by my problem with voiding bladder.
The sickel cell disease test came back negative. Sudafed, which supposed to dilate the blood vessels, did not help. Except one doctor, others have never heard of this kind of condition.
Three questions-
Is there any treatment option that I can try?
What is the prognosis of this condition if I left it untreated?
Could it be caused by bladder neck stricture?
Posted Wed, 27 Aug 2014 in Urinary and Bladder Problems
 
 
Answered by Dr. Naveen Poola 2 hours later
Brief Answer:
No, bladder neck stricture does not cause this problem

Detailed Answer:
Hi,

I am really sorry that you have been facing this problem from past 20 years.

I too would say that your symptoms are not related to spinal or bladder problems. Moreover, most of things which can cause your symptoms have been ruled out by your doctors. However, you are lucky that you do not have any pain since usually, prolonged erection would cause extreme pain.

As many treatments have been tried, surgical treatment involving rerouting of blood flow by implanting a device can be tried. Anyhow, lot of expertise and careful physical exam and extensive work up are required before suggesting this treatment.

No, bladder neck stricture does not cause this problem generally

Regards.
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for prolonged painless erection 19 hours later
Thank you Dr. Poola,
I know it is hard to diagnose or suggest a treatment without seeing the patient and running tests. In general terms, what can happen say after five years, if this prolonged erection condition remains same as it is today?
 
 
Answered by Dr. Naveen Poola 16 hours later
Brief Answer:
permanent damage

Detailed Answer:
Hi,

Usually, permanent damage to the blood vessels of penis may occur if classic prolonged erection occurs for this long. However, I hope that problem is not of that extent to cause permanent damage in your case.

Take care!
Above answer was peer-reviewed by
 
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