• Enduring soft-yet-firm state of the penis
  • Erection strength not as robust as usual
  • Sensory alterations in the penis’ glans, described as a loss of feeling or a cold sensation
  • Discomfort in the penile and perineal regions more notable during micturition and orgasm, especially in an upright position
  • Incidents of erectile dysfunction reported
  • Tension or spasm-like feelings in the muscles of the pelvic floor
  • Psychological strain with symptoms such as anxiousness, depression, lowered sexual interest, and sleep disruption
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Associated Diagnoses

Chronic Pelvic Pain Syndrome (CPPS), Male Pelvic Pain, Chronic Nonbacterial Prostatitis, and Interstitial Cystitis/Painful Bladder Syndrome are all conditions characterized by pain that may be associated with or coexist alongside Hard-flaccid Syndrome.

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Causes of Hard-flaccid Syndrome

  • It may develop following a traumatic incident, such as using a penile vacuum or pump, engaging in rough masturbation or intercourse, manual over-stretching of the penis (jelqing), or excessive squatting.
  • Injury to the base of the penis might affect the nerves or vessels supplying the penis and the pelvic floor muscles.
  • The initial injury that induces emotional distress could hyperactivate a segment of the nervous system, leading to pelvic floor muscle contraction.
  • Prolonged contractions of the pelvic floor muscles may then compress nearby nerves and vessels, resulting in sensory alterations like numbness or a cold sensation, as well as pelvic floor muscle tension and discomfort.
  • The continuous muscle contraction required for achieving and sustaining an erection might compromise the venous structures of the penis, causing it to remain semi-erect when flaccid.

Diagnostic Challenges

Hard-flaccid Syndrome has become the unofficial name for a group of symptoms, born out of internet forums, and is not widely recognized in medical literature, leaving many aspects of it unclear.

Additionally, many symptoms seen in Hard-flaccid syndrome align with those of CPPS/Male Pelvic Pain Syndrome and Chronic Nonbacterial Prostatitis. Despite clear definitions, these conditions present challenges in diagnosis and treatment. Moreover, pelvic floor physical therapists often focus on treating women, but at PHRC in Encinitas, we cater to both men and women.

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How We Can Help You

Men with Hard-flaccid Syndrome can benefit from an evaluation by a specialized pelvic floor physical therapist in Encinitas. During this assessment, the therapist discusses your medical history, symptoms, past diagnoses, and treatment experiences. Understanding your frustrations, the therapist conducts a thorough physical examination, assessing muscles, tissues, nerves, and movement patterns. Afterward, they share their findings and develop an assessment, outlining the symptom origins and establishing short- and long-term treatment goals.

The usual routine for physical therapy in Encinitas extends to 1-2 weekly sessions spanning approximately three months. Complementing these in-clinic appointments, you’ll perform specially designed exercises at home. Your physical therapist is a key player on your healthcare team, working diligently to ensure your treatment plan is cohesive and effective. Our mission is to aid in your recovery and help you lead your best life!