PO-01-037 Hard flaccid: Is It a new syndrome?

Abstract

Hard flaccid (HF) is a cluster of symptoms that significantly affects a man's sexual and social life. Currently, this syndrome has been discussed in numerous patient forums and there is no evidence-based definition yet. We hereby report two cases that suffer from HF and compare their complaints with those reported in patient forums We searched forums, chat-groups, private support groups and social-media (facebook) to collect information about symptoms of HF patients. We have identified several complaints regarding penis, erections, libido, urination and ejaculation. Moreover, we have included findings of the medical tests that are described in HF forums. Majority of the HF patients is in their 20s-30s. They commonly report onset of erection “changes” after a trauma-like event during sexual intercourse. Some HF patients report decreased frequency of morning erections and loss in erectile rigidity. The patients state that their penises are always semi-rigid at the flaccid state and they describe the penile sensation as semi-numb. They have difficulty in achieving and maintaining their erections and most of them require additional tactile or visual stimuli to become fully erect. Moreover, these erectile difficulties seem to change with the alterations in body position as the majority of the HF patients report that their erections are the worst when they are standing. HF can also be accompanied by urination and ejaculation symptoms. Patients are also suffering from psychological issues ranging from mild anxiety to severe depression. Imaging and laboratory tests do not reveal any abnormalities.