A Doctor with Hard Flaccid - Updates and Advice

[Hope77]

Hi Hope77



This is very common. I had that too (and in the beginning it was really terrible). Muscle tension in the Ischiocavernosus muscle increases when we are standing. It is normal to feel relief (and have better erections) while sitting and lying down. We all feel relief lying down.



Good. This is very important as well. Train flexibility in all the muscles I mentioned in the first post - Pelvic Floor, Hamstrings, Psoas, Piriformis, Quadriceps, Adductors and Abs.



You must continue to train flexibility (massages, RKs and stretching), on the pelvic floor. To force the IC muscle to remain flexible even in a standing position.



Yes. Because the muscle tension in the Ischiocavernosus muscle is greater when we are standing. For several weeks I no longer had Hard Flaccid sitting or lying down, but I still sometimes had it standing. The cramp gets worse when we are standing.



You're welcome, Hope77 How has your recovery been? Have you tried EVERYTHING I wrote in the first post?

I wouldn't say i have had much improvement. I can only do reverse kegel when standing (i breath deep to let my diaphragm push on the pelvic floor and hold the stretch). Its hard to do reverse kegel without holding a breath. Maybe advise on a better way.

Also i noticed i cannot flex my anus muscles anymore, infact they are never relaxed and it is difficult to fart. I think being unable to relax anus causes me premature ejaculation. What do you think about this?

 

[Romero MD]

I wouldn't say i have had much improvement. I can only do reverse kegel when standing (i breath deep to let my diaphragm push on the pelvic floor and hold the stretch). Its hard to do reverse kegel without holding a breath. Maybe advise on a better way.

I learned and can do Reverse Kegels in any position and with any degree of Inhale/Exhale
I put 4 of the best threads about Reverse Kegels in the first post of this thread. Please read them all, Hope77. I think it is very important for people to be able to do Reverse Kegels in all ways and all positions. To be able to do them in all daily situations.

Also i noticed i cannot flex my anus muscles anymore, infact they are never relaxed and it is difficult to fart.

Right. It is difficult to contract muscles that are already contracted. This is very common, Hope77. You have muscle tension in the whole pelvic floor (IC + BC + PC). Front and back. You must do Front Reverse Kegels (IC + BC) and Back Reverse Kegels (PC).

I think being unable to relax anus causes me premature ejaculation. What do you think about this?

I also had a lot of Premature Ejaculation in the early days. This happens not by contracture of the PC, but by contracture of the BC. These two muscles are very close to each other. Sometimes it is difficult to distinguish. That said, you treat premature ejaculation mostly with Front Reverse Kegels (IC + BC).


My update:
I made love to my girlfriend yesterday. And I'm getting Delayed Ejaculation... :biggrin1: It's because of the Front Reverse Kegels. I've been doing so many, that the BC is already getting very relaxed :biggrin1:

 

[troublehshooter]

Hi Romero - just wanted to drop by and say thank you for thread and advice. I am at my one year mark almost to the day of HF and some severe CPPS at the beginning. I nearly made a complete recovery several months ago, but a majory foot injury and lots of life stress set me back and I had taken my focus off this problem for a while. This thread is fantastic advice and I think you should write a book. You deserve to be rewarded for your knowledge despite your willingness to give free advice to us . I am implementing all of what you said immediately because you have the explanations to back it. I have done a LOT of research on HF over the years and the one thing I have never tried is a reverse kegel regimen. I'm going to stick to that now and also cut porn out entirely.

The one thing I would like to add that has really helped me is a specific stretch with a TRX strap. Like this, but i move my leg in circles instead of just straight forward: https://www.youtube.com/watch?v=axWqyZZQ2qY. Understand that this is still an indirect stretch of the muscles, but its been a very good one for me. (EDIT: for others that are just finding this, if you have a naturally tense pelvic floor it is great to try to do this exercise while "released" or even reverse kegeling!)

Also, I liked seeing your advice to @HFrecovering. He and I have talked a lot and i wish my advice to him was half as good as yours. it also provided a lot of great information for the rest of us.



Again, Thank you thank you thank you!

 

[Hope77]

Thanks Romero-

Can you now get erection while standing? And have you cured hard flaccid while standing?

 

[Romero MD]

Hi troublehshooter!

Hi Romero - just wanted to drop by and say thank you for thread and advice. I am at my one year mark almost to the day of HF and some severe CPPS at the beginning. I nearly made a complete recovery several months ago, but a majory foot injury and lots of life stress set me back and I had taken my focus off this problem for a while.

You're welcome. I wish you a quick second recovery If you are a person who contracts the pelvic floor a lot with stress, it is normal for the muscles to lose some flexibility again... You have to train a little flexibility (Reverse Kegels, Hindi Squats, etc.) every day.

This thread is fantastic advice and I think you should write a book. You deserve to be rewarded for your knowledge despite your willingness to give free advice to us.

Haha Alright xD I promise that I will think of something more official (book, article), when I have more time in my life. I appreciate the advice and consideration

I am implementing all of what you said immediately because you have the explanations to back it. I have done a LOT of research on HF over the years and the one thing I have never tried is a reverse kegel regimen. I'm going to stick to that now and also cut porn out entirely.

Great!

The one thing I would like to add that has really helped me is a specific stretch with a TRX strap. Like this, but i move my leg in circles instead of just straight forward: https://www.youtube.com/watch?v=axWqyZZQ2qY. Understand that this is still an indirect stretch of the muscles, but its been a very good one for me.

4 months ago, I read your old posts about this exercise And I really liked it! Very ingenious and very interesting. Basically, you're doing the splits with a twist. It is an extremely complete exercise, because it stretches all the muscles that I wrote in the first post (alternately, you have to change the front leg, of course). So, yes, it is a good exercise. I'll even put an update on the first post in honor of your stretch. Thank you for putting it here, troublehshooter!

Also, I liked seeing your advice to @HFrecovering. He and I have talked a lot and i wish my advice to him was half as good as yours. it also provided a lot of great information for the rest of us.
Again, Thank you thank you thank you!

Oh, man... This whole post meant a lot to me.
Thank you very much for all the consideration, for the compliment and for all the kind words. They are all much more important and meaningful to me than any reward.
You're welcome. My pleasure in being able to help you

 

[Romero MD]

Thanks Romero

You're welcome, Hope 77

Can you now get erection while standing?

Yes, and they are gloriously epic

And have you cured hard flaccid while standing?

Almost...

Update 15 weeks after injury:

I went back to weighted calisthenics training. And I feel that after each workout, the penis is a little less soft for 30-60 minutes. But it is nothing compared to the Hard Flaccid of the past.

Sitting and lying down, I haven't had Hard Flaccid in 6 weeks.
Standing, I have a little bit of Hard Flaccid, but it's nothing compared to the Hard Flaccid from 3 months ago. It is much softer. And 90% of the time, when I'm standing, it doesn't even happen, my penis is totally normal. And when it happens (most of the time because I contract the pelvic floor unconsciously), I do Reverse Kegels for 5 seconds and it disappears completely.

The Hard Flaccid like a Rock has completely disappeared. I never had it again, in any position, or situation.

And my sex life is wonderful again. Spectacular erections, extraordinary stamina.
Two days ago I spent about 20 minutes penetrating my girlfriend, standing up, without any sign of PONR. With a rock-hard erection :biggrin1:

As I said, so much flexibility training is giving me Delayed Ejaculation. In addition, I am ejaculating about 2 times a week, now. Without any harmful effect. I notice that the penis only becomes slightly less soft, but it improves quickly, after 1-2 hours.

However (VERY IMPORTANT!) I still do Reverse Kegels: (1) throughout all intercourse, (2) during ejaculation and (3) for a few minutes after ejaculating. And I have also been doing a lot of Hindi Squats after every intercourse. And everything has been cool

I slightly lost the amount of spontaneous erections (20-25 a day), that I was having 2 months ago, but I associate this with the most frequent ejaculations. My libido is not small! But there is more prolactin, less dopamine, it is normal to have less spontaneous erections.
As I said, my libido is scratching the skies. I spend my days thinking about sex and waiting for the day when I make love to my girlfriend again.

So, I am 99% healed. The missing 1% I think is just a matter of continuing to train flexibility for the next few months, a little bit every day (Reverse Kegels, Hindi Squats, muscular stretches, massages, heat, etc...)

Oh! And I am no longer taking supplements. I had already left the drugs, more than a month ago. And now I stopped taking the supplements. Right now I'm just taking very healthy food.

What remains to be resolved:
- Hard Flaccid (soft), from time to time, standing.
- Hard Flaccid (moderate), after workout.
- A slight degree of the left twist. It has improved a lot, but I can still notice a little rotation.

Maybe in a month I will tell you that I am 100% healed

 

[burnout]

@Romero

Fantastic news, so glad for you! I'm also doing no PMO since two weeks together with constant RK throughout the day and hindi squat. What I have noticed is that my morning wood is finally coming back. This is currently all I'm doing without any front/side split stretching to see if this alone is enough.

 

[troublehshooter]

Glad you are recovering! Your dedication has been rewarded.

 

[Oluphil20]

Update on Recovery.
1. I'm seeing improvement on my erection after minutes of exercises but I can't keep my gains. Always going back to zero level.
2. Nocturnal erection is setting me backward. I always injured myself when I'm sleeping. I use to sleep face up and back on ground but I often wake up seeing myself in other positions that would have tempered with my erection which is really really setting me back
3. How can I control involuntary kegel? I have a lot of it when I'm erect. Especially when my girlfriend is around and I'm having spontaneous erection
4. Varicocele is not improving.
5. Most times penis will just be turning, rolling on its own what could this mean?

 

[Romero MD]

@Romero, Fantastic news, so glad for you!

I'm also doing no PMO since two weeks together with constant RK throughout the day and hindi squat. What I have noticed is that my morning wood is finally coming back. This is currently all I'm doing without any front/side split stretching to see if this alone is enough.

Great I am enjoying hearing/reading that

But try to train some general flexibility as well. Like 15-20 min a day. Muscle stretches of the lower body also help.

Keep going, Burnout!

 

[Romero MD]

Glad you are recovering! Your dedication has been rewarded.

Thanks, guys
I hope you all get better too. And as soon as possible

 

[Romero MD]

Update on Recovery.
1. I'm seeing improvement on my erection after minutes of exercises but I can't keep my gains. Always going back to zero level.

Flexibility takes time, Oluphil ... Also, as you said below, Involuntary Kegels. You have to try to eliminate them with Reverse Kegels (light and partial) throughout the day. You cannot let the pelvic floor contract. Otherwise you will be losing the gains.

2. Nocturnal erection is setting me backward. I always injured myself when I'm sleeping. I use to sleep face up and back on ground but I often wake up seeing myself in other positions that would have tempered with my erection which is really really setting me back

Nocturnal erections are not a bad thing. In fact, if you are already having them, it means that the penis is already prepared to have them. It's recovering.
And being able to sleep on your back is great. It is the best position of all. Not only does it help to recover the penis, but it is the position (1) that least damages the posture of your spine, (2) that most decompresses the intervertebral discs and (3) that least damages the flexibility in the other muscles.

3. How can I control involuntary kegel? I have a lot of it when I'm erect. Especially when my girlfriend is around and I'm having spontaneous erection

Reverse Kegels. All day long. They don't have to be intense and total. But try to keep a partial, light and continuous Reverse Kegel, for as long as possible.

4. Varicocele is not improving.

Because your pelvic floor is not improving... By the way, have you seen an Urologist?

5. Most times penis will just be turning, rolling on its own what could this mean?

What do you mean, Oluphil? Please, explain this a little better.

 

[troublehshooter]

Update on Recovery.
2. Nocturnal erection is setting me backward. I always injured myself when I'm sleeping. I use to sleep face up and back on ground but I often wake up seeing myself in other positions that would have tempered with my erection which is really really setting me back

You're going to need to see a doctor about this, but my doctor prescribed me a muscle relaxer for this, as certain ones actually document suppressing nocturnal erections as a side effect. It worked for me. And you probably won't like to hear this, but taking the same drug in the form of a rectal suppository can be very effective at temporarily stopping nocturnal erecetions. (and also help your pelvic floor relax!) This was one of my biggest struggles in the acute stages of my injury. It was cut and dry, if I woke up with morning wood, I knew I was in for a bad day. Its been a long time since that was a problem for me, so don't worry it's temporary.

Nocturnal erections are not a bad thing. In fact, if you are already having them, it means that the penis is already prepared to have them. It's recovering.

I never like to disagree with doctor but this was not my experience! This was a primary complaint I took to several doctors in the acute stages of my injury. My libido, which I was trying to suppress so that I could heal, was working its way into erotic dreams and causing erections in my sleep. As men we all have these but I was experiencing them more than normal at the worst possible time. Often I would wake up in pain at the beginning of an erection from the tissue re-injuring itself. Other times I would sleep through it and feel the injury in the morning. Either way it was torture.

Reverse Kegels. All day long. They don't have to be intense and total. But try to keep a partial, light and continuous Reverse Kegel, for as long as possible.

I've only been doing this for a week now, and only remembering 3-4 hours a day and it is already helping. So yes!!

 

[Dangler]

"For every rule of thumb, there is at least one broken thumb." - author unknown

 

[Romero MD]

I never like to disagree with doctor but this was not my experience! This was a primary complaint I took to several doctors in the acute stages of my injury. My libido, which I was trying to suppress so that I could heal, was working its way into erotic dreams and causing erections in my sleep. As men we all have these but I was experiencing them more than normal at the worst possible time. Often I would wake up in pain at the beginning of an erection from the tissue re-injuring itself. Other times I would sleep through it and feel the injury in the morning. Either way it was torture.

I no longer remembered your story well, troublehshooter. I was now reading your thread again

Summary:
- Cause of injury: Jelqing + Full erection + Kegeling
- Which originated an injury mainly in the right pelvic floor (muscular strain of the right IC/BC), which compressed the right pudendal nerve and, consequently, originated CPPS and Hard Flaccid, mostly on the right side.
- The body/brain did not inhibit erections, after the injury. Full erections during the night worsened the CPPS the next day.

It's an interesting case! It's unusual. For example, penile fractures. Where erections are highly detrimental to wound healing. In most cases, patients do not need to take anti-erection medication. Because the penis will automatically not have them for several weeks/months.
I haven't had nocturnal erections for over a month. But also, I took muscle relaxants almost from the start. It may have influenced a little...

Possibly, you continued to have erections because the entire left side was intact and healthy. Which messed up the information sent to the brain. As Dangler said, this is not common. The brain should inhibit erections when it perceives an injury.

But I agree with you! In your case, erections were not a sign that everything was healing. They were harmful. You did well to take the muscle relaxant. Oluphil, if this is your case, you should also consider a muscle relaxant. In fact, this is well mentioned in my first post... It is odd, and rare, but sometimes the penis is bad for itself

"For every rule of thumb, there is at least one broken thumb." - author unknown

And I think this "author unknown" is quite right
And that is a big and boring hassle, during medical practice... xD

 

[Zaid1997]

Post 141 mentioned variocele and sagging balls, how can we know if it's just the testicles being pushed away due to temperature or variocele?

 

[Romero MD]

Post 141 mentioned variocele and sagging balls, how can we know if it's just the testicles being pushed away due to temperature or variocele?

Finally. One of my favorite patients asking me questions on my thread :biggrin1:
Hi Zaid
Your answer is also in post 141. But thanks for asking again, so there is another post to give importance to this question/issue:

"- So first, you have to be examined by a doctor, to find out if you have a Varicocele."

Guys, I know that many of you don't like Urologists (and that some of you have had bad experiences, and think that doctors are useless) but this is very important. Even if they don't know how to treat your Hard Flaccid, they can do a complete structural examination, to find out if your penis has other abnormalities (skin lesions, rashes, bruises, thrombosed vessels, infections, peyronie's, fibrotic tissue, strained ligaments, varicoceles, etc...). Even if they can't treat you, they can rule out a whole range of injuries, so that your head is more relieved. And so, you can decrease your stress. Which is extraordinarily important.

So, Zaid and everyone, make an appointment, for the doctor to palpate your balls (and your entire penis).

 

[MikeLombardi]

Romero, are you a caribean MD?

 

[TKL_]

So, Zaid and everyone, make an appointment, for the doctor to palpate your balls (and your entire penis)

I actually did this today not knowing you had posted this. He couldn't find any structural irregularities in my genitals by hand palpation. I guess that's somewhat of a relief, but it's not exactly a sophisticated method. I inquired if I should get some structural imaging done, but he said that they wouldn't be of any use in my situation. I don't know why he was so sure, I mean I was laying on the table literally for a single minute while he fondled me. Would've given me the peace of mind at least I guess.

Anyways he came to the same conclusion as you Romero, by diagnosing a constantly contracting pelvic floor muscle. He prescribed me a muscle relaxant and an anti-inflammatory for the next two weeks. He also said that I should buy a heatpad or something like that to sit on top of and to avoid straining excercise.

It just seems so unbelieveable that a pelvic floor muscle strain/contraction would cause over two weeks of total ED, numbness, hard flaccid, reduced bladder sensation, and shift the angle of my flaccid 'hang' downwards. But on the other hand I do have these weird moving radiating sensations right where my BC muscle apparently is, sometimes a moving ball sensation in the perineum, inability to speed up urine flow, and lack of the 'jump' reflex you get when you are ending the urine stream, and straining to flatulate and so on.

 

[TKL_]

Forgot to mention; Going to buy a heat pad and a yoga mat tomorrow.