Hard Flaccid Syndrome Symptoms, Comorbidities, and Self-Reported Efficacy and Satisfaction of Treatments: A Cross-Sectional Survey

Abstract Hard flaccid syndrome (HFS) is a poorly understood condition with no formal consensus on its definition, symptom presentation, etiology, or treatment plan. We aimed to advance the understanding of HFS by evaluating symptom prevalence, cause of symptom onset, comorbidities, and self-reported efficacy and satisfaction with current treatments. An online cross-sectional survey on Qualtrics with purposive and convenience sampling methods were conducted on participants self-identifying as having HFS. Participants were recruited through social media platforms. Only 58% of participants reported their HFS symptoms began following a specific incident/trauma. Changes in penis shape/size and rigid penis when not erect were the most common complaints. Activities such as laying down and stretching improved symptoms while masturbation, weight lifting, and standing worsened symptoms for most patients. Comorbid conditions reported in our sample affect multiple body parts including pudendal nerve, spine, hips, and pelvic region. Self-reported efficacy and satisfaction of current therapies were poor. Innovative, multimodal, and personalized treatment strategies are greatly needed for HFS patients.