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