Department of Urology, Aksaray University School of Medicine, Aksaray, Turkey.
Department of Urology, University of California, Irvine, CA, USA.
Int J Impot Res. 2020 Mar;32(2):176-179. doi: 10.1038/s41443-019-0133-z. Epub 2019 Mar 19.
Hard flaccid (HF) is a group of symptoms that significantly affects a man's sexual and social life. As this syndrome has only been reported in several patient forums, exact prevalence of this rare condition is unknown. Currently, no scientific literature exists of the syndrome. We, hereby, aimed to present four cases suffering from HF and compare the common signs and symptoms with those reported in patient forums. We searched internet forums, chat groups, and private support groups to collect information about symptoms of HF patients. We have identified several complaints regarding penis, erections, libido, urination, and ejaculation. Moreover, we have also collected common findings of laboratory and imaging tests that are used in the workup of HF. The majority of the HF patients is in their 20s-30s. Patients usually seek medical advice due to the following complaints: penile sensory changes (numb or cold), semi-rigid penis at the flaccid state, decreased frequency of morning and/or nocturnal erections, loss in erectile rigidity, difficulty in achieving and maintaining their erections, need for excessive physical or visual stimulation to become erect, and pain on ejaculation and/or urination. Psychological symptoms are usually present ranging from mild anxiety to severe depression. Moreover, laboratory and imaging tests are often unremarkable. Our cases included men between the ages of 22 and 34 years of age and they all reported the onset of their symptoms after a trauma during sexual intercourse or tough masturbation. Compared with reports in patient forums, many of these symptoms (except the urination problems) were observed in our patients and the imaging/laboratory tests were inconclusive. The patients were provided daily/on-demand phosphodiesterase-5 inhibitors, which were not effective. Currently, HF syndrome has not been universally recognized by urologists and a number of patients seem to suffer from this disorder. In order to raise awareness of this clinical phenomenon, HF must be recognized by professional organizations and a better understanding of the disorder must be established.
硬性疲软（HF）是一组严重影响男性性生活和社交生活的症状。由于这种综合征仅在几个患者论坛上报道过，因此这种罕见疾病的确切患病率尚不清楚。目前，尚无关于该综合征的科学文献。因此，我们旨在介绍 4 例患有 HF 的病例，并将其常见症状与患者论坛上报道的症状进行比较。我们在互联网论坛、聊天群组和私人支持群组中搜索信息，以收集 HF 患者的症状信息。我们已经确定了一些关于阴茎、勃起、性欲、排尿和射精的投诉。此外，我们还收集了 HF 患者的实验室和影像学检查的常见发现。HF 患者的大多数年龄在 20 多岁至 30 多岁之间。患者通常会因以下投诉寻求医疗建议：阴茎感觉变化（麻木或发冷）、疲软状态下的半刚性阴茎、晨勃和/或夜间勃起频率降低、勃起硬度降低、难以勃起和维持勃起、需要过度的身体或视觉刺激才能勃起以及射精和/或排尿时疼痛。心理症状通常存在，从轻度焦虑到严重抑郁不等。此外，实验室和影像学检查通常无明显异常。我们的病例包括年龄在 22 岁至 34 岁之间的男性，他们在性交或剧烈自慰期间受伤后都出现了症状。与患者论坛上的报告相比，我们的患者中观察到了许多这些症状（除了排尿问题），而影像学/实验室检查结果不确定。我们为患者提供了每日/按需使用磷酸二酯酶-5 抑制剂，但效果不佳。目前，HF 综合征尚未被泌尿科医生普遍认可，许多患者似乎患有这种疾病。为了提高对这种临床现象的认识，必须由专业组织认识到 HF，并建立对该疾病的更好理解。
