Glans insufficiency syndrome

Glans insufficiency syndrome, also called soft glans or cold glans, is a condition in which the glans penis persistently fails to become erect or turgid during arousal and stays soft and cold. It can reduce sensitivity, make maintaining an erection difficult and lower quality of life. It is usually diagnosed in men who have had penile implant surgery, and is probably underdiagnosed elsewhere because the nomenclature is unclear. Three mechanisms have been proposed: failure to initiate from nerve injury, failure to fill from arterial occlusive disease, and failure to store from fibrosis of the spongiosal erectile tissue causing venous leakage. Causes are multifactorial, including trauma, surgery and vascular disease. Reported rates run from 4 to 60 percent after anterior urethroplasty. Treatment ranges from mechanical and drug measures to venous ligation and implant revision with glanular enhancement.