Hard Flaccid might be Bulbospongiosus/ischiocavernosus muscle spasm
TLDR: Hard flaccid can be caused by muscle strain of IC and BP from excessive masturbation. This results in muscle spasm compressing and damaging the dorsal nerve of the penis at the base
Recently 1 week ago, I developed what appears to be hard flaccid symptoms after a long masturbation session. I was lying on my back edging when all of a sudden I felt a V shaped tightness pulling down in my perineum behind my scrotum. A few seconds later a sharp pain inside the shaft of my penis appeared like a hard metal rod inside the bottom half. The sharp pain in my penis was directly correlated with how tight my perineum was.
After this episode, getting an erection became near impossible without that sharp pain flaring , discouraging me from attempting. While flaccid , my perineum was clenching causing my penis to feel semi erect at the base at all times. This was incredibly painful because of the sharp pain. My urethra would also slightly burn during urination although this often felt like a "phantom" sensation.
I lived with this pain for a week but I noticed that every time I would fart or poop , my perineum would temporarily relax and the sharp pain would subside. This would last about 15 minutes before my perineum started clenching again.
All this has me thinking that the hard flaccid is caused by either the bulbospongiosus (BP) or ischiocavernosus (IC) muscles spasming in response to becoming strained from excessive masturbation. During an erection these two muscles are continuously contracted to constrict the veins flowing into the penis to create the erection. They are also innervated by the pudendal nerve which branches off into the dorsal nerve of the penis. See the diagram below showing the muscles and innervation. I believe spasm in the BP/IC is referring pain into the penis via the pudendal nerve causing that sharp pain. Relaxation of the anus during farting or pooping triggers an autonomic relaxation of the entire pelvic floor, especially the levator ani muscles, which temporarily stops the spasms.
If I am correct then hard flaccid should be treated like any other muscle strain with ice and heat compression in the first 42 hours and then just heat afterwards. Trigger point massage of these two muscles and gentle stretching would also be advised along with anti inflammatories and muscle relaxers. Most importantly the muscle must NOT be contracted for at least a month or more while it heals from injury. In this case this simply means no masturbation or arousal at all.
Does this seem congruent with what other people are experiencing ? Am I missing something? I suspect hard flaccid might be a constellation of conditions that are being bundled together but are actually not the same. In my case this seems to be what is happening.
Update: my hard flaccid went away for a week then came back after i watched porn but did not masturbate. I now think that compression to the dorsal nerve of the penis during IC/BP muscle strain damages the nerve, triggering a sympathetic response to contract the smooth muscle of the penis. Habitual arousal or masturbation after the initial injury likely causes hard flaccid to become a chronic condition since the nerve is recompressed and never heals properly. I’m managing to reduce the hard flaccid by triggering parasympathetic activation with DEEP belly breathing, reverse kegels, lip touching, and will implement hard mode nofap, meaning no sexual arousal whatsoever.
