I'm think out side of the box here, so bare with me
@notmeanymore
Since you talked to multiple urologists but not a specialized pathologists, you might want to get second and third opinion to mine. I'm providing a summary to get my head screwed on correctly:
- Good erection at night and and early in the day, but not during the late morning toward night time during active hours.
- Testosterone level came back an normal. Doctors provided Cialis but not working. Have not tried TRIMIX to test for long erectile capacity all day.
- Sexual activities in the morning can be done, but extreme penile retractive issues after ejaculation and severe drop in libido.
- Left tingling pain on the left and not the right of the glans. No pain or tingling sensation for the remaining area of the shaft. Irritation of the glans during movement. Stinging sensation of the glans throughout the day until resting phase at night.
- Injury to "inner penis" or pelvic tissues due to prior clamping.
- Burning sensation of the penis along the urethra, along the base of the penile shaft.
- Total time of post-trauma is 8.5 months. No more PE since 3.5 months ago. That means you have 5 months of repair and restoration processes.
Let me know if I left out anything, or make modification to the list so far. Let's dive into the situation unless the list and info change significant.
So, for #1, #2 and #3, your testosterone level is considered normal, and libido for your age is typical. This means your system is producing the normal level of hormones.
Now, for the #2, Cialis has no boost in your nitric oxide loading means your bioavailable production is either very low to begin with, or nitric oxide is easily depleted. Low nitric oxide concentration and easily depleted will kill your blood cycling all over the body. This can be one of the libido killer. You might like to supplement your dietary intake with nitric oxide-rich materials. Even though I produce sufficient level of nitric oxide, I still drink L-citrulline malate to boost my nitric oxide concentration daily, either be 2g on days I don't exercise, or 4 to 5 grams on days I do. It's not for sport performance, but for blood cycling to heal my tissues. The bonus is erection quality, something to akin of constantly drinking Cialis. As for erection quality and longevity, you might want to research on TRIMIX as a self application medication when needed, similar to Cialis. The cocktail is a triple mix of what normally work. Each of the compounds in the tri-mixed cocktail compensate for what's not working. Something to think about if you want more erectile quality for longer period.
#3 got me concern a bit. This beg the issue of extreme depletion of free testosterone, oxytocin, dopemine, and high level of cortisole concentration. Further more, your depression may have elevate the cortisole (stress hormone) concentration even higher. Specialists in sexual medicines have to perform a blood test before an after ejaculation after abstaning for 3 to 7 days. By understanding the before and after levels, they can figure out where the hormonal imbalance may be. It may be PE's injuries, but it also flag for something else higher in the body's functions. Your body may truncate all the unnecessary functions, such as libido and erection quality to switch to preservation mode if this happens. There may also be other symptoms that you are not detecting as well beside eratice erectile dysfunctionality.
#4 flag the dorsal peroneal nerve branch damage (top nerve travelling at the top of the penile shaft). One side feels tingly, and the other side is not. However, nerve repairs within 3 to 5 months period at max. What concerns me more is the possible blood clotting or semi-clotted in one of the capillaries, or multiple. I'm not there to visually inspect at a microscopic level so I can give you a good evaluation. This is where the specialist may give you a secondary opinion once they observe at close range. This is why I warn the brothers to use baby aspirins if they plan on doing intense PE routines. However, using a thick wall penis sleeve, loosely around the shaft reaching to 1/2 of the glans, provide a soft medical grade cover such as Theraband or even a silicone cap over the glans to prevent irrigation of clothing upon contact of the glans, and maintain elongation to get the blood continue to flow in a passive method. This was suggested a few posts ago. Elongation of the penile body passive forces blood to flow through the area. This promotes healing proceses.
#5 doesn't make sense. Damage to pelvic muscles heal over time. Those who performed extreme kegel/reverse kegels and injuried themselves require betwen 3 to 14 months of healing as the tissues repair. Rather than kegel, they revert to pelvic type exercises, such as squats, lunges, or hip weight bearing resistance type of training to recover faster. This goes for penile injuries as well when those who "fractured" their penis from too much sexual activities. Penile injuries in this arena range from 3 to 18 months of recovery time based on serverity of the injuries.
#6 is the odd part. Urethra burning sension is internal tissue damages. Urethra damages heal within 5 to 10 days. For it to prolong this far out, something is greater than just the internal injury. I've pulled up a few cases where cancerous growth near, around, and at the urethra causes that odd burning sensation. Those who have prostate cancers also reported the odd burning sensation at the base of the penis as well. So, do check up on the possibility of the prostate cancer if you haven't done so.
#7 is an odd prolong repair/healing time. Do light exercises to get more blood to flow into the pelvic region while eating and drinking properly. Healing processes is not about staying stagnant and just wishing it away. It's also the pursue of nurturing the injury to heal faster. We'll act as a secondary source of info for you, but do seak professional helps as well. There are way too many flags that doesn't make sense at this point in time.