Testicular Pain and Erectile Issues After Injury

Regarding my genitalia?

Hello doctor, on November 7th, while I was taking the bus, I got caught between the door and a pole due to the crowd.
I managed to squeeze out, but my genital area was pinched, and I hit my testicles as I came out.
After that, I felt dizzy and couldn't stand, so I squatted down to rest.
Once I got to school, I checked my genital area and didn't notice anything unusual, so I didn't worry too much.
However, a few days later, I realized that I wasn't experiencing morning erections, and my left testicle was a bit painful.
I was having difficulty achieving an erection, which made me anxious, so I went to see a doctor.
After taking medication for a day or two, I was still very worried and had trouble sleeping.
On November 14th, I visited the urology department at Mackay Memorial Hospital.
The doctor examined my genital area and said there were no abnormalities, the size of my testicles was normal, and any issues would be visible externally.
There were no significant bruises or anything, and he told me not to worry too much and to rest well.
(At that time, I really doubted why no further tests were done or why no medication was prescribed.) Recently, I have had morning erections, but I still find it difficult to achieve an erection, and when I do, it tends to go soft easily.
I have tried masturbation, which allows me to ejaculate normally, but I am really worried about what might be wrong, as it feels very different from before.
I'm quite concerned, and I would appreciate your help, doctor.

Nìmíng, 10~19 year old female. Ask Date: 2011/11/26

Dr. Xu Weikai reply Urology

The doctor examined and said there are no issues, indicating that there should be no injuries, meaning there shouldn't be any significant problems.
If there is erectile dysfunction, further relevant tests are needed, such as penile ultrasound and erection tests, to confirm the diagnosis.

Reply Date: 2011/11/26

More Info

Testicular pain and erectile issues following an injury can be concerning and may stem from a variety of causes. Based on your description, it seems that you experienced a significant trauma to the genital area, which can lead to both physical and psychological effects.
Firstly, it's important to understand that trauma to the testicles can result in several potential complications, including bruising, swelling, or even more serious conditions like testicular torsion or rupture. However, your initial examination by the urologist indicated that there were no visible signs of severe injury, such as swelling or bruising, and that the testicles were of normal size. This is a positive sign, but it does not completely rule out underlying issues.

The pain in your left testicle could be due to several factors. One possibility is that the trauma caused some degree of inflammation or irritation in the area, which can lead to discomfort. Additionally, the psychological impact of the injury should not be underestimated. Anxiety and stress about your sexual health can lead to erectile dysfunction (ED) or difficulty achieving and maintaining an erection. This is sometimes referred to as psychogenic ED, where psychological factors play a significant role in sexual performance.

The fact that you are experiencing morning erections again is a good sign, as it indicates that there is still some level of physiological function. However, the difficulty in achieving erections during other times could be related to anxiety or stress about your situation. It is not uncommon for individuals who have experienced trauma to have heightened anxiety regarding their sexual health, which can create a cycle of worry that exacerbates the problem.

In terms of management, here are some steps you can consider:
1. Follow-Up with a Specialist: If your symptoms persist or worsen, it may be beneficial to seek a second opinion or further evaluation from a urologist. They may recommend imaging studies, such as an ultrasound, to rule out any internal injuries that may not be immediately apparent.

2. Psychological Support: Consider speaking with a mental health professional who specializes in sexual health or trauma. They can help you address any anxiety or stress related to your injury and its impact on your sexual function.

3. Lifestyle Adjustments: Engage in activities that promote relaxation and reduce stress, such as exercise, meditation, or yoga. These can help alleviate anxiety and improve overall well-being.

4. Open Communication: If you are in a relationship, discussing your concerns with your partner can help alleviate some of the pressure you may be feeling. Open communication can foster understanding and support.

5. Patience and Time: Recovery from trauma can take time, both physically and psychologically. It’s important to be patient with yourself as you navigate this process.

In conclusion, while your initial examination did not reveal any severe issues, the combination of physical trauma and psychological stress can lead to symptoms like testicular pain and erectile dysfunction. Continued monitoring of your symptoms and seeking appropriate support can help you on your path to recovery. If you have any further concerns or if your symptoms change, do not hesitate to seek medical advice.

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