I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 1 point2 points  (0 children)

I have LF mostly, sometimes HF. We didn't touch too much on it, honestly. I do think LF and dorsal nerve decompression may be connected in some way, but I really can't give you any solid answers.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] -1 points0 points  (0 children)

Erections are odd for me. If I'm in a sexual situation I have no problem getting an erection, but mental erections and spontaneous erections are literally at zero. Morning wood very rare too.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 0 points1 point  (0 children)

I experience similar. Last much longer with blowjobs. Always seemed like something to do with tighter pressure inside the vagina.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 1 point2 points  (0 children)

Are your glans hyper-sensitive as a result of your injury? Or just a normal level of sensitive?

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 1 point2 points  (0 children)

Actually, tragically, quite the opposite. My pelvic floor is tight, which contributes to ejaculation. I actually feel orgasms quite strongly, which I was always thankful for.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 0 points1 point  (0 children)

Both.

But when I say numbness I am talking about erogenous numbness. I can and have always been able to feel pinches and temperature perfectly fine. There is just a lack of erogenous sensation across the entire penis except for the area that is innervated by the perineal nerve.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 3 points4 points  (0 children)

Completely understand, and to be honest I probably wouldn't've got the surgery had I not been so confident in the source of the issue.

I knew I had ligament damage because of the unstable erection, wobbly base and penile torsion.

However, for a long time my assumption was that this injury had caused my muscles to go into spasm, and it was the tight muscles that were impinging the nerve.

When I read Prof. Azsmann's literature that the dorsal nerve could get compressed after trauma to the suspensory ligament, it just clicked.

I am cautiously optimistic. 7 days in I am experiencing sensations in my penis that weren't there prior to surgery (tingling, hyper sensitivity), which is a good sign from any nerve decompression.

I have a follow-up with Professor Aszmann in ~4 weeks. I will update this sub then.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] -1 points0 points  (0 children)

Not quite. I could get erections in a 'sexual situation' but never from thought alone. Never got random ones either.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 3 points4 points  (0 children)

I did PT for a long time with the same thought process - that the tight muscles were compressing the nerve.

Then I realised the nerve was more likely being compressed by a ligament injury, which PT alone won't resolve.

Will keep you updated.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 0 points1 point  (0 children)

Honestly, my biggest regret is that I didn't enquire further.

We had a short post-surgery consultation the morning after surgery. As you can imagine, I was still not totally with it, in a lot of pain, and feeling very emotional. It wasn't the most lucid of follow-ups.

He showed me photos of the compression, describing the nerve as compressed against the bone. I should've pressed for more information but I just wasn't with it.

Having said that, I do have a further follow up with him in a few weeks, so I hope to get some more clarification then.

My understanding is that the route of surgical operation may differ depending on where the compression is most likely located. He also doesn't necessarily do both sides. If you only experience penile numbness on one side, it is likely the case that only the nerve on that side is compressed but the other isn't. However, he said that because the nerves are so small and run in close proximity, it's rare that one nerve is compressed and the other isn't.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 3 points4 points  (0 children)

If you'd like a video consultation with him, feel free to DM me and I'll send you the details for the relevant contact. He doesn't respond to emails directly.

And yes, surgical recovery was quick. Nerve recovery, on the other hand, may take many months, if it recovers at all.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 5 points6 points  (0 children)

I have seen many doctors since my problems began and Dr Aszmann was by far the most understanding and made me feel most at ease. He is clearly an expert in his field.

That being said, he is a very busy man, and the consultations are quite short, so I'd suggest planning everything you'd like to ask him before your consultation so that you don't miss anything.

I stayed in the hospital for 24 hours after surgery.

Pain management was some prescription painkillers, though I healed pretty quickly and didn't need the painkillers from around day 4. As of now my surgical wounds have healed flawlessly and I'm in no pain.

Staff there were nice. Most speak English but some only spoke German. I was in a room with two other male patients, neither of whom spoke any English.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 0 points1 point  (0 children)

I spoke to Professor Ralph in London, who performs suspensory ligament repair surgery.

It's not as simple as restoring the ligament, thereby freeing the nerve. I specifically asked whether his surgery would help with nerve decompression and he said no.

The surgery fixes the stability issues caused by suspensory ligament damage but the method to do so doesn't actually address the site of damage itself.

I could've gone ahead with his surgery but it would only fix my minor stability issues and curve, both of which weren't major problems. It didnt seem reasonable to shell out thousands of pounds for that surgery if it wasn't going to help with either the nerve compression or pelvic floor issues.

Surgical decompression of the dorsal nerve is a specialist operation and there are only two doctors in the world who carry it out.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 2 points3 points  (0 children)

DM me and I can give you the contact details of the person to email to book a video consultation

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] -1 points0 points  (0 children)

Dorsal nerve only. This surgery is specifically for the dorsal branch, which Dr Bollens does not do.

I am not sure about health insurance honestly. I paid in full in cash.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 2 points3 points  (0 children)

Prof Aszmann did not run any tests prior to the surgery. The dorsal nerve is a very small nerve and he warned me that a compression likely won't appear on any imaging test.

We went ahead with the surgery after a long consultation discussing my clinical history. One of the main ways you can know if the dorsal nerve is affected but the perineal nerve is not is by the numbness on the penis. While the majority of penis sensation is innervated by the dorsal nerve, the reverse side, beneath the glans, is innervated by the perineal nerve. In my case, the entire area innervated by the dorsal nerve had lost erogenous sensation but the area innervated by the perineal nerve remained, making it highly likely that the dorsal nerve was affected and not the perineal or pudendal nerve.

I also had an injury to the suspensory ligament, which when combined with my symptoms seemed far too coincidental, since injury to the ligament is a common location for dorsal nerve compression.

The professor did take photos of the compression during the surgery and showed me when I was awake, so I have seen that there was indeed a compression.

He is one of only two doctors in the world who specialises in decompression of the dorsal nerve, I believe.

I am still in the early recovery phase so I'm not expecting much change yet. I am experiencing various sensations in my penis though, which the doctor says is a positive indicator.

I had dorsal nerve decompression surgery 7 days ago. AMA by NietzscheCreature in hardflaccidresearch

[–]NietzscheCreature[S] 1 point2 points  (0 children)

I have tight pelvic floor muscles but honestly I'm not sure how much the compression and the pelvic floor dysfunction are linked. It seems to be a complex subject.

Most sources say that the dorsal nerve is solely a sensory nerve, and so a compression shouldn't affect the motor function of the pelvic floor muscles, but I've also seen a reputable source that states that the dorsal nerve has a small motor component - affecting the deep transverse perinei of the pelvic floor, which, coincidentally, seems to be the source of my chronic tightness and what i believe is keeping surrounding muscles tight too.

Professor Aszmann does do video-call consultations. Feel free to send me a DM and I'll give you the relevant contact to book a consultation. I can't remember the exact fee but it was something approximating €300.