Mechanical instability, pelvic pain and unusable erections after catheterisation and hematomas – looking for real experi

[Kebab27]

Hi everyone,

I am 29 years old and I’m looking for advice or real-life experiences from people who developed severe functional problems despite still having erections.

This started in April 2025 after a downward bending injury during sexual activity, which caused a penile shaft hematoma. Initially it was diagnosed as plaque/Peyronie’s, but later confirmed to be a hematoma.

In May 2025, because of difficulty voiding (which I now understand was likely caused by prostatitis and pelvic muscle spasm), I underwent catheterisation with a 14Fr Tiemann catheter. The catheter got stuck at the bulbar/pelvic curvature and had to be advanced forcefully. The sensation was extremely painful, like tissue tearing inside the pelvis.

From that moment my condition progressively worsened.

Over the following months:
• erections became extremely rigid but painful and unnatural,
• I woke up 4–5 times every night with painful erections,
• urination and bowel movements became difficult,
• pelvic muscles went into constant tension,
• pain localized mainly to the root/bulbar region and left side.

Later:
• a second shaft hematoma occurred after being advised to resume use,
• ligament support progressively weakened,
• eventually a left crus hematoma developed,
• after this event erections temporarily disappeared and later returned with tadalafil, but much worse and mechanically unstable.

Currently:
• I still have erections even without tadalafil, but they are mechanically unusable,
• tolerable only when standing and lifting the penis upward toward the abdomen and slightly to the right,
• lying down causes bending or buckling under the testes,
• sitting is almost intolerable due to pressure and pain,
• ejaculation worsens symptoms for days,
• there is continuous discomfort and a feeling of structural change at the root,
• the underside of the shaft feels thinned and poorly supported.

MRI studies were largely reported as normal, but ultrasound identified:
• a small 2×1 mm scar under the shaft (likely source of earlier bleeding),
• organizing hematoma near the left crus,
• asymmetry compared to the right side.

My Qmax declined over time (27 → 20 → 14 ml/s), and my prostate enlarged significantly. After starting antibiotics for prostatitis and tamsulosin, sleep and bowel function improved somewhat, confirming that inflammation played a role — but the mechanical problems remained.

I have been taking amitriptyline since September for pain modulation and sleep. I have also been evaluated multiple times by psychiatry and proctology; both specialties referred me back to urology, as no primary psychological or colorectal cause was found.

Despite extensive consultations, I have not yet received a clear treatment pathway. Most recommendations have been conservative or contradictory, while my quality of life has significantly deteriorated over the past 9 months.

I am currently in pelvic floor therapy and have tried conservative treatment extensively.

Several surgeons told me:
• stabilization might only be possible with an implant,
• others said I am too young,
• and some suggested no intervention because imaging appears mostly normal.

I have consulted multiple specialists in my country, as well as Dr. Kuehhas (Austria), Dr. Djordjevic and Dr. Djinovic (Serbia). I am currently waiting for a joint consultation with Anthony Mundy and David Ralph in London.

A penile Doppler study was not completed because I reacted poorly to intracavernosal injection during a previous attempt, and the radiologist advised against repeating it.

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My current main problems:
• erections exist but are unstable and painful,
• constant root/bulbar discomfort,
• position-dependent symptoms,
• difficulty with urination and bowel movements unless posture is modified,
• inability to have normal sexual activity,
• persistent pelvic and left-sided pain.

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My questions:
1. Has anyone here had an implant primarily for mechanical instability and pain, despite preserved erections?
2. Were root or ligament-related issues addressed before implantation?
3. Did implantation improve daily function (sleep, sitting, urination comfort), not just intercourse?
4. Has anyone recovered functional stability without implant after similar trauma?

I am not looking for miracles — only a stable, usable condition and a normal life again.

Thank you for reading

[indeed]

My history is very similar to yours.

Also happend to me around your age, same instability and other symptoms, i also had significantly reduced erection quality with it though. I could get erections, but they were short lived and not "strong".

I first got suspensory ligament repair with Dr. Ralph which helped a bit but not nearly enough.

Got implant after that, 3 years ago. Everything was fine, it even solved my pain i had at the base.
Now i'm facing some issues with the impalnt though and might need a revision, unrelated to the ligament tough.

In my opinion you should try other options first.

1. Suspensory ligament repair with Ralph, which he'll probably recommend you try before implant. (He did recommend for me). In my opinion this surgery isn't enough for a severely instable base. They just put a few stitches in the middle on top of your dick and attach it to the pubic area. It gives no real "sideway" stability.

2. There is a novel surgery for suspensory lig repair. From what i've seen, the take some ligament out of your leg, and use that as a new ligament. This probably creates a much more stable and durable repair. Also i'ts natural tissue that will grow in and be more stable long term.
Cons: It's new, i think info is limited. Also i think the surgeon is in australia.

https://www.semanticscholar.org/paper/% ... 214b99dbea

Good luck