Is it normal for the flaccid penis to change texture?

This may be a silly question, but here goes. Is it normal for the penis in the flaccid state to change texture. Sometimes my penis in the flaccid state is soft and long and sometimes its as hard as a rock and short.  Is the scar tissue causing this?

Greetings,

You pose your question asking about the flaccid state of your penis presenting different textures, and present your observations that seem to be contradictory. 

You mention one state is soft and long, and the other is hard and short.   This last description sounds very much like an erection that is  shortened because of the inability to lengthen due to contraction of the penile soft tissue, and not another state of a flaccid penis.  It is not consistent to say that you are both flaccid and hard as a rock.   For the most part, you are either soft or hard, flaccid or erect, but not at the same time. 

The erection process is complex and the presence of the Peyronie's plaque or scar, a foreign mass of collagen tissue situated within the erectile tissue, can created some unusual reactions and alternations of the usual erection a man can experience.

I think perhaps what you are confusing is the lack of lengthening of your erect Peyronie's penis with still being flaccid.  TRH

Is it possible my Peyronies scar is like a piano wire?

Dr. Herazy, I wrote you last month and you really helped my confidence with what I am doing. Is it possible that my PD scar is like a piano wire from the base to the head? That is the only irregularity I can find. Thanks Dick R.

Greetings Dick,

Yes, it is certainly possible that your scar feels like a piano wire. The Peyronies plaque or scar material presents in a wide variety of ways, just as most everything about PD seems to be variable. 

Although you did not say so, I will guess the long ridge of scar material tissue you say feels like a piano wire is located on the top or dorsal surface of the shaft.  This is a very common location for long narrow PD scars.  It is the anatomical structure, called a septum, where the tunica albuginea of the two chambers meet in the mid-line, and it runs from the base of the penis to the head (glans).   This septum is especially susceptible to separation during trauma, and can consequently develop a long thin scar.  

You can assume this is your only, or your primary, Peyronie's scar if your curved penis is directed upward.  

While you might be correct that it is only as thin as a piano wire, I suggest that you examine this thin ridge again to determine if you can detect that it tapers down to a flat band.  Almost like the gable roof of a house, your piano wire structure might just be like the uppermost ridge of the roof that gets thinner as it slopes down laterally.  I mention this speculation because it is always beneficial to have a clear and accurate visualization of each scar so you can closely monitor it  for changes as you continue to treat your PD. 

You might find, if I am correct, that this flat tapered surface on either side of the piano wire will undergo changes in size, shape, density and surface features as your scar deteriorates as your treatment progresses. 

If you do not know it is there, you will not have this useful information available to you to guide your treatment.  You must try to know everything there is to know about each of your Peyronies scars.

TRH

Is it adviseable to needle the penis directly?

Dr. Herazy,

I am an acupuncturist treating a patient with Peyronie's disease.  I bought your "Peyronie's Disease Handbook,"  hoping you had included specifics on the use of acupuncture, especially whether or not you think it's advisable to needle the penis directly?  I know you advise to not cause additional injury to the penis, but needling near scar tissue on other parts of the body is not contra-indicated, but actually beneficial.

What are your thoughts on this please? My patient is willing to try anything.

Greetings Doctor, 

Yes, needling a superficial scar on other parts of the body is very often beneficial, but the penis is a different part of the body. I would not needle the penis for concern of puncturing the tunica albuginea and further extending his Peyronies problem.  My concept is never to puncture the tunica in an attempt to help this problem. 

However, local treatment has always been an important part of my acupuncture practice, such as the famous Circle the Dragon technique, and that is why I advocate heavy use of the Genesen Acutouch pens to treat the PD lesion in this particular way because it will not risk injuring the patient by avoiding compromise to the tunica.

If you feel required to needle, distal points are always advisable. I do not treat a lot based on Five Elements theory, but I believe you would likely benefit your patient by evaluating for an Excess Wood situation.  Bear in mind that the “Peyronie’s “scar” is not a scar in the traditional sense of being a superficially located skin lesion; it is below the subdermis and within the tunica so the standard methods of needling a scar – that I have done daily for over 35 years – does not apply to PD.  At least, that is how I understand it based on my concept and methodology in guiding Peyronie's treatment.

If you feel obligated to needle, distal points are always advisable such as SP3, SP6, K3, GB34, the master points of the Conception Vessel, Sedation points for the Wood element and and Stimulation points for the Fire element. as well as appropriate Eight Extraordinary Meridian points (Du Mai, Chong mai, Yin Wei mai, etc.)    TRH