It's all that self-abuse you practice! Leave it alone for a while and you
won't even require meds.

Find a topic site for life's rejects and in time you may even find someone
from the same group who'll treat it with gentility for you.

Doctor, you know I have the greatest respect for you and your work,
although your alma mater and mine are arch rivals.

However, I must respectfully disagree with you.  The pt's severe
distress is indicative of the seriousness of his condition.  Surgery,
and only surgery is needed in this case.

The pt's spontaneous micturition is only symptomatic.  As suggested by
Dr. kompressor, the root cause is his compulsive onanistic behavior.

His need for human interaction is very important, yes, and is
exacerbated by the hopelessness of his current state.

The operation I am proposing will leave him a eunuch, but you cannot be
suggesting his current life is any better.