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.

⸻

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.

⸻

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

[Kebab27]

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

In my case the most difficult part right now is the constant pulling and tension feeling at the base and along the underside of the penis. Since the catheterisation I can clearly feel an “irritated line” where the catheter got stuck, and the tissue there feels very different — more rigid, uneven and mechanically restricted. Erections are still possible, but they feel structurally altered and unusable, and the sensation is very different from before.

What has been mentally very hard is that for months erections were extremely strong and frequent, waking me several times every night, and then after the hematomas everything progressively changed and became unstable and painful. Living through that transition — from very rigid erections to this current unstable and painful state — has been very difficult, and I honestly fear that things may never return to normal.

If you don’t mind me asking, I would really like to understand your case a bit better:
• Did your original problem also involve pelvic or perineal pain, or was it mainly erection instability?
• Did you feel a constant pulling or tension at the base, like something mechanically restricting movement?
• When you had the suspensory ligament repair, did Dr. Ralph mention finding scar tissue or abnormal healing around the base or crus area?
• Were your symptoms position-dependent (for example better standing and worse lying or sitting)?
• Before the implant, did you also have problems with urination or bowel movements related to pelvic tension?

I’m trying to understand whether cases like yours were mainly ligament instability, or whether deeper tissue or scar-related problems at the root were involved.

Thank you again for taking the time to reply — it really helps to hear real experiences.

[indeed]

Trust me i know how you feel.

- I had pelvic problems including numbness, feeling of coldness, some pelvic pain etc but just for a short time. After a few months those were all gone.
What i was left with was very unstable base and weak erections.
- I did not, mine felt more like a lack of support / a clear ligament tear on the right side
- He didn't mention that, but he did mention that my suspensory ligament was actually intact. loose, but intact. I always suspected the problem was my fundiform ligament anyway.
- a bit, i could get much better erections standing
- I had urination & pelvic symptoms after my ligamnet accident for a few months. after that no

In my experience it's almost impossible to pinpoint the exact problem with such cases, and even if, options are limited. Best you can do is live healthy and work on your pelvic floor.
Definetly look into pelvic floor recovery stuff, and also give it time. I still had improvements a year after my accident.

Good luck man

If you don’t mind me asking, I would really like to understand your case a bit better:
• Did your original problem also involve pelvic or perineal pain, or was it mainly erection instability?
• Did you feel a constant pulling or tension at the base, like something mechanically restricting movement?
• When you had the suspensory ligament repair, did Dr. Ralph mention finding scar tissue or abnormal healing around the base or crus area?
• Were your symptoms position-dependent (for example better standing and worse lying or sitting)?
• Before the implant, did you also have problems with urination or bowel movements related to pelvic tension?

I’m trying to understand whether cases like yours were mainly ligament instability, or whether deeper tissue or scar-related problems at the root were involved.

Thank you again for taking the time to reply — it really helps to hear real experiences.

[Kebab27]

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

In my case the most difficult part right now is the constant pulling and tension feeling at the base and along the underside of the penis. Since the catheterisation I can clearly feel an “irritated line” where the catheter got stuck, and the tissue there feels very different — more rigid, uneven and mechanically restricted. Erections are still possible, but they feel structurally altered and unusable, and the sensation is very different from before.

What has been mentally very hard is that for months erections were extremely strong and frequent, waking me several times every night, and then after the hematomas everything progressively changed and became unstable and painful. Living through that transition — from very rigid erections to this current unstable and painful state — has been very difficult, and I honestly fear that things may never return to normal.

If you don’t mind me asking, I would really like to understand your case a bit better:
• Did your original problem also involve pelvic or perineal pain, or was it mainly erection instability?
• Did you feel a constant pulling or tension at the base, like something mechanically restricting movement?
• When you had the suspensory ligament repair, did Dr. Ralph mention finding scar tissue or abnormal healing around the base or crus area?
• Were your symptoms position-dependent (for example better standing and worse lying or sitting)?
• Before the implant, did you also have problems with urination or bowel movements related to pelvic tension?

I’m trying to understand whether cases like yours were mainly ligament instability, or whether deeper tissue or scar-related problems at the root were involved.

Thank you again for taking the time to reply — it really helps to hear real experiences.

I noticed you mentioned that your implant was done by a different surgeon — was there a particular reason it wasn’t done by Mr. Ralph?

[Kebab27]

Trust me i know how you feel.

- I had pelvic problems including numbness, feeling of coldness, some pelvic pain etc but just for a short time. After a few months those were all gone.
What i was left with was very unstable base and weak erections.
- I did not, mine felt more like a lack of support / a clear ligament tear on the right side
- He didn't mention that, but he did mention that my suspensory ligament was actually intact. loose, but intact. I always suspected the problem was my fundiform ligament anyway.
- a bit, i could get much better erections standing
- I had urination & pelvic symptoms after my ligamnet accident for a few months. after that no

In my experience it's almost impossible to pinpoint the exact problem with such cases, and even if, options are limited. Best you can do is live healthy and work on your pelvic floor.
Definetly look into pelvic floor recovery stuff, and also give it time. I still had improvements a year after my accident.

Good luck man

If you don’t mind me asking, I would really like to understand your case a bit better:
• Did your original problem also involve pelvic or perineal pain, or was it mainly erection instability?
• Did you feel a constant pulling or tension at the base, like something mechanically restricting movement?
• When you had the suspensory ligament repair, did Dr. Ralph mention finding scar tissue or abnormal healing around the base or crus area?
• Were your symptoms position-dependent (for example better standing and worse lying or sitting)?
• Before the implant, did you also have problems with urination or bowel movements related to pelvic tension?

I’m trying to understand whether cases like yours were mainly ligament instability, or whether deeper tissue or scar-related problems at the root were involved.

Thank you again for taking the time to reply — it really helps to hear real experiences.

Thank you for your reply — it was reassuring in some ways, but also difficult to read because I recognize parts of my situation in what you describe.

I am currently doing male pelvic floor therapy, spine rehabilitation, and I have also seen holistic practitioners, but unfortunately I still feel very lost. Many doctors seem to dismiss my symptoms because imaging is mostly normal, even though the functional problems are very real for me.

Since the catheterisation, erections have become extremely uncomfortable and unnatural. Lying down they are weak and unstable, bending or buckling easily. When I lift the penis upward, erection quality improves somewhat, but there is a pulling and tearing sensation at the exact place where I felt the catheter getting stuck. That area also feels harder from the urethral side and the shape is different from before.

The overall tactile feeling of the penis has changed — it feels less mobile, as if there is a scar band preventing normal movement, possibly involving the spongiosum or even the opposite corporal side. The worst discomfort is at the base where it enters the pelvis.

What makes this especially difficult mentally is that before all this I likely had prostatitis and pelvic muscle spasm, and instead of conservative treatment I underwent catheterisation, after which everything progressively worsened. Since starting antibiotics for the prostate recently, sleep has finally improved after more than a year, which makes me think inflammation played a major role — but the mechanical symptoms remained.

Standing erections can still be relatively strong, but they feel restricted and painful, with a flat or indented area where the injury occurred. Urination and bowel movements remain the most difficult daily functions, and these symptoms affect my quality of life more than sexual function itself.

At this point I honestly struggle to imagine how this could return to a normal state. My andrologist is the only doctor who takes my complaints seriously, but even he does not yet have a clear solution, and surgeons both locally and abroad seem unsure because the symptoms are complex.

I appreciate you sharing your experience — it helps to hear from someone who went through something similar.

If you don’t mind me asking — did your penis also feel structurally different to the touch after the injury, or was it mainly instability without this “scar band” sensation

[indeed]

First to your other reply: I went to Clavell beacse the US surgeons mostly use the no touch technique, which lowers infections risk. I regret going to Clavell now though, i think he oversized me.

Man i know how incredibly hard this condition is trust me. In my experience, doctors are absolutely 100% useless for this. I've yet to read of a single guy a doctor could fix with this condition. I've seen people get healthy, but by lifestyle/themselfes or maybe a PT, not by a doc.

Pelvic floor PT can help, but listen to your body. I can tell you, my biggest improvement / best feeling after the injury was after about a year when i went to vacation in Thailand. Just not worrying, walking a lot in the sun, swimming, relaxed. No PT, no Workouts not doctors. I think my nervous system calmed down there so much, that it worked better than everything before.

I tried a lot of things, some helped some not. What helped me was: nightly 20 mg viagra before sleep, walking a lot, relaxing on vacation, not stressing out my dick by checking it or mastrbuating a lot.
What possibly helped me: AngionMethod (on reddit - be careful though), Peptides injected into my pubic fat


I did not feel a scarband, but yes my penis felt structurally different, especially in the flaccid state. I would alternate beteween the hard and long flaccig (squishy). That went mostly away after about a year around my vacation. Sadly after that i reinjured myself because of my weak base, thats why i got implant.

Have your doctors done a doppler on you to check for scar tissue? In my opinion the first thing you need to know if there is scartissue thats growing (Peyronies).
If not, thats good you have time and no need to stress. If yes, should monitor it closely with your doctor.

You can shoot me a DM if you want to

Thank you for your reply — it was reassuring in some ways, but also difficult to read because I recognize parts of my situation in what you describe.

I am currently doing male pelvic floor therapy, spine rehabilitation, and I have also seen holistic practitioners, but unfortunately I still feel very lost. Many doctors seem to dismiss my symptoms because imaging is mostly normal, even though the functional problems are very real for me.

Since the catheterisation, erections have become extremely uncomfortable and unnatural. Lying down they are weak and unstable, bending or buckling easily. When I lift the penis upward, erection quality improves somewhat, but there is a pulling and tearing sensation at the exact place where I felt the catheter getting stuck. That area also feels harder from the urethral side and the shape is different from before.

The overall tactile feeling of the penis has changed — it feels less mobile, as if there is a scar band preventing normal movement, possibly involving the spongiosum or even the opposite corporal side. The worst discomfort is at the base where it enters the pelvis.

What makes this especially difficult mentally is that before all this I likely had prostatitis and pelvic muscle spasm, and instead of conservative treatment I underwent catheterisation, after which everything progressively worsened. Since starting antibiotics for the prostate recently, sleep has finally improved after more than a year, which makes me think inflammation played a major role — but the mechanical symptoms remained.

Standing erections can still be relatively strong, but they feel restricted and painful, with a flat or indented area where the injury occurred. Urination and bowel movements remain the most difficult daily functions, and these symptoms affect my quality of life more than sexual function itself.

At this point I honestly struggle to imagine how this could return to a normal state. My andrologist is the only doctor who takes my complaints seriously, but even he does not yet have a clear solution, and surgeons both locally and abroad seem unsure because the symptoms are complex.

I appreciate you sharing your experience — it helps to hear from someone who went through something similar.

If you don’t mind me asking — did your penis also feel structurally different to the touch after the injury, or was it mainly instability without this “scar band” sensation

[Kebab27]

First to your other reply: I went to Clavell beacse the US surgeons mostly use the no touch technique, which lowers infections risk. I regret going to Clavell now though, i think he oversized me.

Man i know how incredibly hard this condition is trust me. In my experience, doctors are absolutely 100% useless for this. I've yet to read of a single guy a doctor could fix with this condition. I've seen people get healthy, but by lifestyle/themselfes or maybe a PT, not by a doc.

Pelvic floor PT can help, but listen to your body. I can tell you, my biggest improvement / best feeling after the injury was after about a year when i went to vacation in Thailand. Just not worrying, walking a lot in the sun, swimming, relaxed. No PT, no Workouts not doctors. I think my nervous system calmed down there so much, that it worked better than everything before.

I tried a lot of things, some helped some not. What helped me was: nightly 20 mg viagra before sleep, walking a lot, relaxing on vacation, not stressing out my dick by checking it or mastrbuating a lot.
What possibly helped me: AngionMethod (on reddit - be careful though), Peptides injected into my pubic fat


I did not feel a scarband, but yes my penis felt structurally different, especially in the flaccid state. I would alternate beteween the hard and long flaccig (squishy). That went mostly away after about a year around my vacation. Sadly after that i reinjured myself because of my weak base, thats why i got implant.

Have your doctors done a doppler on you to check for scar tissue? In my opinion the first thing you need to know if there is scartissue thats growing (Peyronies).
If not, thats good you have time and no need to stress. If yes, should monitor it closely with your doctor.

You can shoot me a DM if you want to

Thank you for your reply — it was reassuring in some ways, but also difficult to read because I recognize parts of my situation in what you describe.

I am currently doing male pelvic floor therapy, spine rehabilitation, and I have also seen holistic practitioners, but unfortunately I still feel very lost. Many doctors seem to dismiss my symptoms because imaging is mostly normal, even though the functional problems are very real for me.

Since the catheterisation, erections have become extremely uncomfortable and unnatural. Lying down they are weak and unstable, bending or buckling easily. When I lift the penis upward, erection quality improves somewhat, but there is a pulling and tearing sensation at the exact place where I felt the catheter getting stuck. That area also feels harder from the urethral side and the shape is different from before.

The overall tactile feeling of the penis has changed — it feels less mobile, as if there is a scar band preventing normal movement, possibly involving the spongiosum or even the opposite corporal side. The worst discomfort is at the base where it enters the pelvis.

What makes this especially difficult mentally is that before all this I likely had prostatitis and pelvic muscle spasm, and instead of conservative treatment I underwent catheterisation, after which everything progressively worsened. Since starting antibiotics for the prostate recently, sleep has finally improved after more than a year, which makes me think inflammation played a major role — but the mechanical symptoms remained.

Standing erections can still be relatively strong, but they feel restricted and painful, with a flat or indented area where the injury occurred. Urination and bowel movements remain the most difficult daily functions, and these symptoms affect my quality of life more than sexual function itself.

At this point I honestly struggle to imagine how this could return to a normal state. My andrologist is the only doctor who takes my complaints seriously, but even he does not yet have a clear solution, and surgeons both locally and abroad seem unsure because the symptoms are complex.

I appreciate you sharing your experience — it helps to hear from someone who went through something similar.

If you don’t mind me asking — did your penis also feel structurally different to the touch after the injury, or was it mainly instability without this “scar band” sensation

Thank you for your reply, I really appreciate it.

Unfortunately a penile Doppler study could not be completed in my case. During an attempt last October an implant surgeon injected 2.5 µg alprostadil on the right side and asked me to sit outside. I became partially erect but had severe pain. Sitting is very uncomfortable for me and my last hematoma happened in a similar situation. After 20 minutes he injected the left side as well, I developed intense warmth and numbness, felt unwell, lost the erection suddenly and ended up in the emergency department overnight. Because of this reaction the radiologist advised against repeating Doppler.

Instead, high-resolution ultrasound and elastography showed a small 2×1 mm scar under the shaft near the urethra (same area where both earlier hematomas originated), external urethral scarring, and an organizing hematoma near the left crus. The left side below this point is flatter and asymmetric, which is also where the catheter got stuck. There is also periosteal inflammation and suspected injury to the fundiform and suspensory ligaments.

Since then erections exist but are mechanically unusable. Standing is somewhat tolerable, but lying or sitting causes bending, instability and pain. The base feels restricted and there is a constant pulling/burning sensation where the penis enters the pelvis. The tissue on the left side feels structurally different and less mobile.

I stopped tadalafil because nocturnal erections were extremely painful. With antibiotics for prostatitis, amitriptyline and anti-inflammatory treatment sleep and general condition improved somewhat, but functionally nothing returned to normal. Any attempt at use in the past months resulted in new bleeding or worsening symptoms.

I recently saw Prof. Mundy in London and am currently waiting for a joint examination with David Ralph.

At this point my main issue is not achieving erection, but that erections feel mechanically restricted and painful, and daily function (urination, sitting, movement) remains difficult

Thank you i write