What about "Venous Leak"

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From WebMD:

What Is a Venous Leak?

Your penis must store blood to keep an erection. If the veins in the penis cannot prevent blood from leaving the penis during an erection, you'll lose your erection. This is called venous leak. Venous leakage may occur with vascular disease. Venous leakage is also associated with diabetes, Peyronie's disease (buildup of scar tissue in the penis that leads to curved, painful erections), certain nerve conditions, and even severe anxiety.


A man in his 40's who is rebooting - Re: Is this PIED? Help with ED!

RE: venous leak, I discussed that with my urologist. He said he could test for it but -

  1. The test is uncomfortable and expensive;
  2. If I do have a venous leak, he would be very slow to recommend surgery because of the difficulty and limited number of excellent outcomes--so you're testing for something and usually can't use the data for anything useful; and
  3. It is uncommon especially in younger guys (...in this case I'm considered younger even though I'm late forties). In addition, if you are getting morning wood and/or nocturnal erections, then the chance of leakage being the cause of ED is slim.

At the time, I would very infrequently get morning wood, so for a while I thought leakage might be my problem. But after hitting no PMO hard and perfectly for just a few weeks, my morning wood starting coming back.  After a couple of no-relapse months last year, I had wood the vast majority of mornings.

I also thought I might have damage due to physical trauma. Because of some sports activities I've been involved in, I've taken numerous hard and painful hits to the groin. He dismissed that as a possibility saying the type of trauma I would have had to incur would be the type that would send me to the ER with an extended stay in the hospital....not just the occasional hit to the family jewels even if it's hard enough to take me out of the game.

Obviously, all of this is anecdotal and based on my specific issues. My main point: the chance of porn and your fapping habits being the problem seems infinitely greater than some of these other things.


Age 28 - ED Cured: Experiences & Theories on My Different Type of PIED


The false diagnosis of venous leak: prevalence and predictors.

J Sex Med. 2011 Aug;8(8):2344-9. doi: 10.1111/j.1743-6109.2011.02298.x. Epub 2011 May 13.

Teloken PE, Park K, Parker M, Guhring P, Narus J, Mulhall JP.

Source

Department of Surgery, St John of God Hospital, Perth, Australia. patrickteloken@gmail.com

Abstract

INTRODUCTION:

As a vascular test, dynamic infusion cavernosometry (DIC) has lost popularity, and in the urologic community, penile duplex Doppler ultrasound (DUS) has become the sole test to investigate a vascular etiology of erectile dysfunction. Vasoactive agent redosing has been shown to increase the accuracy of DUS.
AIM:

To define the erectile hemodynamics in men with previously diagnosed venous leak on DUS.

METHODS:

Prospective data were collected on patients who (i) had been given a diagnosis of venous leak based on an outside DUS; (ii) elected to undergo a repeat DUS; and (iii) when the repeat DUS suggested venous leak, underwent DIC.

MAIN OUTCOME MEASURES:

DUS: peak systolic velocity and end-diastolic velocity. DIC: flow to maintain.

RESULTS:

292 patients were included. Mean ± standard deviation age was 44 ± 26 years. On repeat DUS, 19% (56/292) had completely normal hemodynamics and 7% (20/292) had arterial insufficiency only without venous leak. DIC revealed normal hemodynamics in 13% (38/292), while in 58% (152/292) of patients, the venous leak diagnosis was confirmed. Overall, 47% (137/292) of patients who had been given a diagnosis of venous leak had completely normal hemodynamics, and in only 43% (126/292), the venous leak diagnosis was confirmed upon repeat vascular testing. On multivariable analysis, younger age (<45 years), failure to obtain an adequate erection during the original DUS, and having <2 vascular risk factors were predictive of a false diagnosis of venous leak.

CONCLUSIONS:

Penile DUS has a propensity to inaccurately assign a diagnosis of venous leak. Great care should be taken when performing DUS especially in younger men without a significant vascular risk factor history, and the failure to obtain a good erection should make the clinician cautious in assigning a diagnosis of venous leak. Furthermore, there still exists a role for cavernosometry, which appears to have a greater accuracy at diagnosing venous leak.

© 2011 International Society for Sexual Medicine.