So went to see the Urologist again today, I always feel rubbish after going to these appointment, I have just got to the point where I hate having to discuss things with doctors. Seen so many damn doctors it seems recently!
So he firstly reviewed my blood test results which he thought was still broadly speaking alright. They are really at the lower limit of normal though (borderline really). I think if I pushed he would have boosted my testosterone, but I can understand why he was reluctant to. It can come with its own problems boosting testosterone and it might not do anything as many people on this forum have seen. That being said, I don’t know whether I would benefit from testosterone being boost really. Maybe I would? Am I producing enough to ‘heal’ the penis? Perhaps for the time being I should trust him.
He still seemed confident that I would improve and get better in the coming months. He thought I needed more time. He felt that finasteride had tipped me over the edge for ED but that my recovery was being prolonged by anxiety and worry about all this. I am not sure I agree with that really. He does not thing there is anything structurally wrong with the penis (although no examination, scan, etc).
I asked about doing an ultrasound scan with an injection of the penis so its performed when erect. He was not keen as he felt these scans prove nothing and show nothing, He said it is entirely possible for a young man to be nervous which produces adrenaline which inhibits the chemical being injected (adrenaline it turns out is the antidote to the injected chemical to cause the ereciton). He had no problem performing an injection on my to ‘prove’ i can get an erection and maintain it since this is a psychological block for me at the moment. Its probably worth doing just to prove to myself I can get a normal-ish erection.
He doesn’t believe in venous leakage (well, unless you are born with it or have had some kind of surgery). Since I was alright pre-finasterdie with erections (well, they were fine, I was never a pornstar though!), he I won’t have a venous leak. He said if I can’t maintain an erection, it is more due to not enough blood flow being pumped into the penis to make it fully rigid. Again, I wasn’t entirely sure about this!
With regard to shockwave, he said I could do it but he felt the money might be better spent on psychosexual counselling. He said I am very anxious about all this and I think he though I would recover faster with this really. I really hate it when people talk about anxiety and PFS really. I was anxious before PFS too but I could get a normal-isn erection. There is definitely something physical going on here.
I think this just shows there is no magic bullet really. Shock wave may well not help and would just be expensive. He’s probably right about the testosterone. And of course stay on tadalafil long term.
I disagree with a lot of what he says. But … is he sort of right? I mean, maybe the only real way to recover form this is time and tadalafil? Testosterone could screw me up more and shockwave is a gamble really?
I actually got sent an appointment today to see an NHS Andrologist which is good at the end of the month. I think my plan is to give it more time and see how I’m improving. If I’m no further after a month, I can as the NHS for the scan with injection and potentially still do the shockwave privately (the doctor today said I could if I wanted to, he just didn’t know if it would work). Will also keep testing testosterone although this may go up because of the vitamin D
So yeah, its just super frustrating that there is no clear path forward really, no established treatments for all this. Everyone is in the dark and there are no guarantees with anything. I think time and tadalafil are the best route for now. And Vitamin D!
Will let you guys know how I’m getting on and we can re-assess things when the NHS appointment comes around in a few weeks.