Hard flaccid (HF) is a group of symptoms that significantly affects a man’s sexual and social life. As this syndrome has only been reported in several patient forums, exact prevalence of this rare condition is unknown. Currently, no scientific literature exists of the syndrome. We, hereby, aimed to present four cases suffering from HF and compare the common signs and symptoms with those reported in patient forums. We searched internet forums, chat groups, and private support groups to collect information about symptoms of HF patients. We have identified several complaints regarding penis, erections, libido, urination, and ejaculation. Moreover, we have also collected common findings of laboratory and imaging tests that are used in the workup of HF. The majority of the HF patients is in their 20s–30s. Patients usually seek medical advice due to the following complaints: penile sensory changes (numb or cold), semi-rigid penis at the flaccid state, decreased frequency of morning and/or nocturnal erections, loss in erectile rigidity, difficulty in achieving and maintaining their erections, need for excessive physical or visual stimulation to become erect, and pain on ejaculation and/or urination. Psychological symptoms are usually present ranging from mild anxiety to severe depression. Moreover, laboratory and imaging tests are often unremarkable. Our cases included men between the ages of 22 and 34 years of age and they all reported the onset of their symptoms after a trauma during sexual intercourse or tough masturbation. Compared with reports in patient forums, many of these symptoms (except the urination problems) were observed in our patients and the imaging/laboratory tests were inconclusive. The patients were provided daily/on-demand phosphodiesterase-5 inhibitors, which were not effective. Currently, HF syndrome has not been universally recognized by urologists and a number of patients seem to suffer from this disorder. In order to raise awareness of this clinical phenomenon, HF must be recognized by professional organizations and a better understanding of the disorder must be established.

硬性松弛症（HF）是一组会严重影响男人的性生活和社交生活的症状。由于仅在几个患者论坛中报告过该综合征，因此尚不清楚这种罕见病的确切患病率。当前，没有关于该综合征的科学文献。在此，我们旨在介绍四例患有心力衰竭的病例，并将其常见症状和体征与患者论坛中报告的症状和体征进行比较。我们搜索了互联网论坛，聊天组和私人支持组，以收集有关HF患者症状的信息。我们发现了一些有关阴茎，勃起，性欲，排尿和射精的投诉。此外，我们还收集了用于HF检查的实验室检查和影像学检查的常见发现。大多数心力衰竭患者在20多岁至30多岁。患者通常会因以下主诉而寻求医疗建议：阴茎感觉改变（麻木或感冒），半刚性的阴茎处于松弛状态，早晨勃起和/或夜间勃起的频率降低，勃起僵硬度降低，难以达到和维持其状态勃起，需要过度的物理或视觉刺激以勃起，以及射精和/或排尿时疼痛。通常会出现心理症状，从轻度焦虑到重度抑郁。此外，实验室和影像学检查通常不显着。我们的病例包括22岁至34岁之间的男性，他们都报告了性交或硬手淫中的外伤后出现症状。与患者论坛中的报告相比，在我们的患者中观察到了许多这些症状（排尿问题除外），并且影像学/实验室检查尚无定论。每天/按需为患者提供无效的磷酸二酯酶-5抑制剂。当前，HF综合征尚未被泌尿科医师普遍认可，并且许多患者似乎患有这种疾病。为了提高对这种临床现象的认识，HF必须得到专业组织的认可，并且必须更好地了解这种疾病。