Hard Flaccid Syndrome's Effect on Erections and Sexual Function

Today, we are delighted to have Dr. Josh Schammel back with us. Dr. Schammel is a third-year urology resident at Albany Medical College, and he brings valuable insights into the mysterious realm of Hard Flaccid Syndrome (HFS). In this episode, we'll delve into the impacts of HFS on erections and sexual function.

Hard Flaccid Syndrome (HFS) is marked by a semi-rigid penis in the flaccid state, loss of erectile rigidity, penile sensory changes, and psychological distress. It predominantly affects men in their second or third decade of life.

The syndrome is often associated with trauma or micro trauma to the penis, commonly at the penile base. Activities like using penile pumps, vigorous sexual intercourse, masturbation, and even excessive squatting with weights can contribute to HFS. Patients with HFS may experience numbness, decreased sensitivity, and penile/perineal pain. Diagnosing HFS involves evaluating the Sexual Health Assessment for Men (SHAM) or the International Index of Erectile Function (IIEF) score. However, traditional imaging studies like penile Doppler often appear normal, adding complexity to the diagnostic process.

HFS management is multifaceted. Biological interventions include physical therapy for pelvic muscle spasms, medications like sildenafil, and pain control. Psychosocial aspects involve addressing relationship issues, coping strategies, and breathing exercises.

 

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Fig. 3 | Potential pathophysiology of hard–flaccid syndrome. A trauma-like event, for example, sustained during masturbation or sexual intercourse, might harm the pudendal nerve and/or artery at the level of the radix penis, which could trigger penile hypoxia, inflammation, and neuropathy. Neuropathy and penile hypoxia can result in symptoms of coldness and numbness in the penile shaft and glans, whereas muscle spasms might be responsible for chronic prostatitis/chronic pelvic pain syndrome-like voiding symptoms. Furthermore, emotional stress arising from hard–flaccid syndrome (HFS) might worsen pelvic muscle spasms and further deteriorate the patient’s symptoms in a vicious cycle.

 

Hard Flaccid Syndrome - PART 1

What is Hard Flaccid syndrome? What are the causes? How is it treated? Dr. med. Dr. phil. Stefan Buntrock, a board-certified urologist and sexologist from Göttingen discusses these questions with professor Irwin Goldstein from San Diego. Hard Flaccid syndrome is a debilitating condition often...

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