About Hard Flaccid Syndrome
Hard flaccid syndrome is a painful pelvic condition that affects sexual function, sensation to the penis, and in some cases, urination. It can affect people with penises across the age spectrum, from the second to seventh decade of life, but is most commonly seen in 30–50- year-olds. In addition to the physical characteristics, studies have shown that emotional distress, such as anxiety, depression, decreased libido, and insomnia often arise.
Hard flaccid syndrome may present after a traumatic event to the genitalia with delayed onset ranging from a few minutes to a few weeks. Symptoms may also present insidiously, or with unknown cause. Although research suggests that, like other chronic pelvic pain syndromes, it’s onset may be due to a myriad of factors such as physiological, psychological, and social contributions.
How is Hard Flaccid Syndrome diagnosed?
Diagnosis for hard flaccid syndrome can be frustrating because it is a diagnosis of exclusion. Blood tests, urine tests, hormone (PCA) tests, MRIs, ultrasounds, and cystoscopies will come back normal. Many people with hard-flaccid syndrome are often misdiagnosed. A thorough history of one’s symptoms and lifestyle, as well as a thorough examination performed by a pelvic floor physical therapist can assist in detecting hard-flaccid syndrome. The examination may include internal rectal and external perineal (area between scrotum and anus) and abdominal assessments to determine if muscular tension in the pelvis is present.
What are common treatments for Hard Flaccid Syndrome?
Research has shown that a combination of various treatments has been the most effective in treating hard-flaccid syndrome. Common treatments include behavioral modifications to improve sleep, diet, and physical activity, biofeedback, breathing exercises, cognitive behavioral therapy, yoga, stress management, and pelvic floor physical therapy. In addition to conservative treatment, symptoms such as pain may be managed by medications and should be discussed with your physician.
What Does the Pelvic Floor Have to do with Hard Flaccid Syndrome?
There are many structures within the pelvis that surround and make up the genitalia, including various nerves, arteries, veins, and muscles. The nerves, arteries, and veins to the penis run through the pelvic floor muscles. For the penis to have adequate sensation and blood supply, the pelvic floor muscles must be in a relaxed state.
With hard-flaccid syndrome the pelvic floor muscles are in a tightened position which restricts venous outflow from the deep dorsal vein of the penis thus causes a rigid penis in a flaccid state. The dorsal branch of the pudendal nerve that innervates the penis may be compressed by muscular tension which can impair sensation to the penis, which can often be described as numb. Stress caused by these symptoms further increases the body’s sympathetic nervous system better known as our “fight or flight response” which increases pelvic floor muscle activation. Pelvic floor physical therapy can help to alter this vicious cycle of pain, tension, and stress to reduce sympathetic nervous system activity.
Pelvic floor physical therapy is an effective and holistic treatment approach to reduce pelvic floor muscle tension with manual therapy, teach optimal breathing patterns, provide stress management techniques, and educate on lifestyle modifications that will help reduce the body’s fight or flight response to ultimately improve symptoms.
Common Symptoms of Hard Flaccid Syndrome
Symptoms of hard flaccid syndrome can present in many different ways. This is by no means an exhaustive list, but here are some of the most common signs and symptoms we see at Beyond Basics Physical Therapy:
How Pelvic Floor Physical Therapy Can Help
Physical therapy is a practice of healing that restores function and reduces pain through the use of techniques to improve bony alignment, reduce trigger points, and improve muscle coordination and strength. Pelvic floor physical therapy is a branch of physical therapy and is built upon these same principles. What sets pelvic floor physical therapists apart is their in depth understanding of the muscles and surrounding structures of the pelvic floor, beyond what was taught in physical therapy graduate school. What that means for a patient who is seeking the help of a pelvic floor physical therapist, is that pelvic floor issues will be examined and treated comprehensively with both internal and external treatment, they will be provided with lifestyle modifications to help remove any triggers, and receive specific exercises and treatment to help prevent the reoccurrence of pain once he or she has been successfully treated.
Beyond Basics Physical Therapy: We Can Help
Get help now from a pelvic floor physical therapist for hard flaccid syndrome.