Dr. Herazy,
I spoke with you on the phone this evening, Friday May 11th. I sincerely thank you for taking the time to talk with me. Much appreciated. I will be ordering your book as my first step.
If I operate under the assumption that my situation is in fact Peyronie's disease, it would be safe to assume since my symptoms of curvature and pain started about a month ago that I am in the initial stages of the syndrome. I have two questions for you:
1. Is it beneficial to achieve erection and masturbate in this stage? My thought is that this may have some benefit in protecting from scarring, similar to prescribed rehab after a knee surgery. In that example the patient manipulates the joint frequently to break up formed and forming scar tissue. Would this be useful?
2. Do you recommend or discourage the use of Viagra and the other similar drugs in this period? Could they help or hurt healing?
Thanks again for your time. I will keep you posted!
R. Brown
Greetings R.
As you recall, I mentioned that there are often many irregularities and inconsistencies in the way Peyronies disease will present itself; it is rare to find someone with a classic text book presentation. Since your particular symptoms and history does not strongly suggest that you have PD, and only a few a small part that does, I suggest you consult with a second urologist to confirm one way or the other your actual diagnosis.
That masturbation might be beneficial for Peyronies' disease because exercise of joint after surgery is a standard therapy, is a flawed comparison. What you are proposing would not be much different than watching movies after eye surgery, smelling flowers after nose surgery or listening to music after ear surgery. In Peyronie's disease the lesion or problematic tissue is relatively passive or non-functional relative to sexual activity. Even though it is obviously the primary structure that is involved in sexual activity and it certainly gets involved, in my opinion there is limited and minimal direct therapeutic benefit to masturbation for Peyronie's disease. Having said that I think there is considerable secondary or indirect benefit. Masturbation is helpful not only from an emotional basis, but also due to the increased blood circulation that occurs during any type of sexual activity. I doubt that frequent or occasional masturbation would make a great difference to your eventual recovery, one way or the other, but if it feels good and it benefits you even a small amount then that is probably reason enough to do it.
While exercise to rehabilitate a damaged joint and weak muscles are obviously appropriate and necessary therapy for a bony articulation that is meant to move and muscles that are meant to contract, none of this applies to the corpora cavernosa, corpora spongiosum or tunica albuginea of the penile shaft.
If I have not stated the point clearly enough, allow me another round at it. While there might be small and indirect benefit to masturbation if you have any stage of Peyronie's disease, I am sure the direct therapeutic benefit is only minimal. I get the sense from your question that you had the idea you could "masturbate your way out of PD." To the extent this is what you had hoped, the answer is no.
All sexual activity, especially masturbation, for a man with Peyronie's disease should be gentle, easy and non-traumatic in every way possible. A critical part of being as gentle and easy on yourself is to use an above average amount of personal lubrication to avoid abuse to the involved tissue. Easy does it. If it hurts, even a little, stop doing and never repeat whatever does not feel pleasant to you. One of the worse things you can do for yourself would be to reduce or alter your usual and customary sexual activity simply because you have Peyronie's disease. Many men do this, and it sets up an attitude of defeat and hopelessness that is not beneficial for eventual recover. Go at it, sir, but be careful.
I can tell you a long list of sad stories related to me by teenage boys who developed Peyronies after injuring themselves while using rough and exotic masturbation practices; more 14 and 15 year old virgin boys than you would imagine, who will never have intercourse in their lives if they follow the standard medical advice of "do nothing until I say it is time for Peyronie's surgery."
I have written extensively about the frequent situations in which the use of the PDE5 inhibitor drugs (Viagra, Cialis, Levitra) can precipitate injury to the delicate tunica albuginea of the shaft and lead to Peyronie's disease. You can search the archives for these articles, but a few are "Peyronie's disease plaque, Viagra, Cialis, Levitra and blood supply" and "Viagra, Cialis, and Levitra use with Peyronie's disease," and" Viagra Peyronie's disease connection."
Please let me know if I can help you in any other way. TRH