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No such thing as Traumatic Masturbatory Syndrome

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I have a couple of questions about erectile dysfunction.

I have problems getting or maintaining erection for quite some time now. Though this was mainly about erection at the time of masturbation (and no problem with orgasms). I checked with a few GPs (not urologists) in different times. And they checked my blood pressure, testosterone level, and also some urine sample test which I don't recall for what reason, and those seemed fine at the time of the test. I was told that the cause of the problem can also be stress or depression. And it is difficult to deal with my case while I'm not in a relationship (I haven't been into one for quite a while as well).

Now recently I barely get an erection, and my organisms are weak too. What has changed recently is the new environment and new job. More stability in my life (fortunately) and I'm busy with my work mostly, but maybe inner depression, or better say "lack of libido" if you may call it! Needs to be said that I have mild bipolarity with depression tendency as well. And I've been taking low to medium doses of Sodium Valproate and Seroquel XR for quite some time now. But these aren't new. I also smoke, but not too much (6 to 8 cigarettes a day for 5 or 6 years), and I drink a couple pints of bear every week.

I'm actually not looking for a quick advice to cure my erectile dysfunction here! Since as I understand many factors are involved and it needs more care and attention through time. But I have two other questions:

I used to hear about the negative effect of "prone masturbation" in erectile dysfunction or even organisms. Something as some people call "Traumatic Masturbatory Syndrome". I searched about this in web but to me looked like there is no reliable or scientific base to this. I asked about this from the GPs I mentioned, but I couldn't get a clear answer. Is TMS real?

Another thing that I've noticed, is my Perineal raphe and I think it has become a bit wider, and darker (brown). To be honest I'm not sure about this. I don't know if I've just become sensitive about it, or is it really darker or wider than before. And even if it is, is it because of ageing or some other reason. But my second question is, can Perineal raphe in any ways be related to erectile dysfunction or organisms?

I would appreciate if you can give answers to these two questions. By the way, I am 32 years old.


Category: Urologist

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Category: Andrologist
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Thanks for your consult at DoctorSpring and the detail history.

There is no such well defined term like 'Traumatic masturbatory syndrome' in urology, so nothing much can be discussed about that. Masturbating in prone position is fine if you are doing it against soft surface. If you are doing it against hard surface it can lead to trauma.

As per your history you are smoker and also consume alcohol occasionally. They both have negative impact on your erection profile. To know the cause of erectile dysfunction you should go for penile doppler study with caverject injection (to rule out vascular cause). Anti depression medication also have negative effect on erection but more on libido.

You are 32 years old and sexually active so its better you plan for treatment of ED ( Erectile Dysfunction ).
Regarding darkening of median raphe, you have to send me the photographs to reach a decision/ diagnosis.

Hope this helps, Would be glad to answer any follow-ups.
Dr Gautam Banga
Reconstructive Urologist

Patient replied :

Hi Gautam,

Thanks for the clear answers. Ok then. I think it's a good idea for me to arrange the test you mentioned (penile doppler study with caverject injection) with a local lab then.

I've also attached some images I took of my median raphe (hope they are clear enough). As you can see, it is brownish on the skin on my testicles, and more reddish on my penis skin.

Also one other thing, recently (and I guess since about the same time of my major erectile dysfunction problem), my penis is most of the time shrank to its minimum length. I don't know if this gives you any new information, but just thought to mention. I've also included the image in the photo I've attached.


Scrotal skin can appear dark because it stays in a corrugated form and have various sweat glands, penile skin is relatively laxed. It has nothing to do with your erectile profile.
If penis is not erect it stays in contracted/ flaccid state and size depend on outside temperature . If you will stimulate the organ it will gradually increase in size. My advice is get that color doppler study done and on the basis of that we decide the line of treatment.

Dr Gautam Banga

Dr. Gautam Banga
Category: Andrologist
MS Surgery: MGM Medical College & M.Y Hospital Indore
Residency: M.Ch, Urology, SMS Medical College & Hospitals Jaipur
Medical School: MBBS, BJ Medical College, Pune, 2001
Training in Urethral Reconstructive surgery: Kulkarni Reconstructive Urology center, Pune
Dr. Gautam Banga and 4 other Medical Specialists are ready to help you

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