Which Specialist Should I See for My Urological Concerns?

Which specialty should I consult with the doctor?

Hello Doctor: I have not engaged in sexual intercourse, only masturbation.
I previously underwent surgery for left-sided varicocele.
Over the past two years, I have been experiencing persistent soreness and numbness starting from my lower back, extending to my groin and down to my thighs.
The soreness and numbness intensify when I have an erection or after ejaculation, and my penis becomes flaccid immediately after ejaculation.
My erectile function has also declined, as it becomes soft quickly.
Sometimes, I experience a slight aching sensation in my penis, and it feels softer than before even when not erect, as if blood is not flowing properly to the penis.
What could be the cause of this? If I need to seek medical attention, should I see a general surgeon or a urologist?

jack, 30~39 year old female. Ask Date: 2019/02/16

Dr. Xu Wencang reply Urology

First, let's have a look at the urology examination.

Reply Date: 2019/02/16

More Info

Based on the symptoms you've described, it would be most appropriate for you to consult a urologist for your concerns. Urologists specialize in the urinary tract and male reproductive system, which includes conditions related to erectile dysfunction, penile health, and any complications arising from previous surgeries, such as your history of varicocele repair.

Your symptoms, including persistent pain and numbness from the lower back to the groin and thighs, along with erectile difficulties and discomfort during erections or ejaculation, suggest that there may be underlying vascular or neurological issues affecting blood flow and nerve function in the pelvic region. The fact that you have a history of varicocele surgery is particularly relevant, as this condition can sometimes lead to complications that affect erectile function and sensation.

Erectile dysfunction (ED) can be multifactorial, often involving psychological, hormonal, or vascular components. Given your description of the penis becoming soft shortly after erection and the associated pain, it is crucial to rule out any vascular issues that could be impeding blood flow to the penis. Conditions such as arterial insufficiency or venous leakage can lead to the symptoms you are experiencing. A urologist can perform specific tests, such as a Doppler ultrasound, to assess blood flow to the penis and determine if there are any vascular abnormalities.

Additionally, the numbness and pain radiating from your lower back to your legs could indicate a neurological issue, such as nerve compression or damage. This could be related to a herniated disc or other spinal issues that may be affecting the nerves that innervate the pelvic region. While a urologist can address the erectile dysfunction and penile health, it may also be beneficial to consult a neurologist or an orthopedic specialist if the neurological symptoms persist or worsen.

In summary, I recommend that you see a urologist first to address your erectile dysfunction and any related symptoms. They can perform the necessary evaluations and, if needed, refer you to other specialists for further assessment of your neurological symptoms. It is essential to address these concerns comprehensively, as they can significantly impact your quality of life and overall well-being. Don't hesitate to seek medical attention, as early intervention can lead to better outcomes.

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