Friday, April 19, 2024

Venous Leak Treatment Without Surgery

Case Presentation And Diagnosis

Treatment of Erectile Dysfunction due to Venous leakage

A 47-year-old man was diagnosed with erectile dysfunction due to suspected venous leakage following an urological intervention not further specified 20years ago. Patient especially complains about insufficient penile rigidity and early penile relaxation during sexual activity. Furthermore, he is a non-responder to PDE-5-inhibitors. Patient was assessed with an International Index of Erectile Function Questionnaire score of 43 indicating moderate erectile dysfunction.

Why Dont Pumps Work

If the pump is used with a ring, then the ring attempts to maintain the erection. It does so by physically compressing the dorsal veins to “shut off” the blood outflow. This can sometimes be effective, and some men have good results with regular rings.

However, many men find the rings that come with pumps don’t work as effectively as hoped. They find that after the pump is removed, the erection starts to go soft. Other men find the erection stays until they attempt intercourse, then it goes soft.

The reason rings that come with pumps often aren’t effective is because they tend to move around. They slide over the penile skin due to lubrication and body fluids in the area, or they slide along the penile shaft due to the penile skin itself moving along the shaft. During intercourse the normal thrusting action accentuates the movement of the ring back and forth along the penile shaft.

This continuous small movement causes blood to leak from the erection under the ring, which causes the erection to go soft or to be lost.

Percutaneous Treatment Of Venous Erectile Dysfunction

  • 1SwissIntervention Microtherapy Center, Bern, Switzerland
  • 2University of Bern, Bern, Switzerland
  • 3Vascular Institute Central Switzerland, Aarau, Switzerland

Erectile dysfunction is a defined as recurring inability to achieve and maintain satisfactory erection for sexual intercourse associated with relevant life impairment. The underlying etiologies may be manifold and complex. Currently, vascular etiologies are highly prevalent especially amongst elderly men. Of special interest, especially venogenic causes are of increasing relevance. Therapeutic options comprise risk factor modification, pharmacotherapy, surgical treatment, and endovascular treatment. Especially endovascular treatment options have recently increased in popularity including transcatheter embolization procedures for veno-occlusive dysfunction.

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How Do You Fix Venous Leak

New York Urology Specialists reports that “Veno-occlusive dysfunction is one of the most challenging problems to treat. For some patients with mild venous leak, ED medications might work. Using a penile constrictive ring might allow men to maintain erections for a prolonged period of time. Some men are successful in using vacuum erection devices or penile injections in combination with a penile constrictive ring.

Read Real Stories Of Men Who Underwent Treatment For Ed At New York Urology Specialists

Before And After Photos Pictures of Varicose Leg Veins, Happy Patients ...

We offer ED treatment to patients within driving distance to our offices as well as from other states and countries. Our patients come from New York, New Jersey, Pennsylvania, and Connecticut, and over 30 countries worldwide.

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Symptoms Of Venous Leakage

Venous leakage is characterized by a few prominent symptoms, namely:

  • No early morning erections or nocturnal erections
  • Soft erections which do not support penetration

Furthermore, theres a key difference between ED caused by arterial insufficiency and venous leak erectile dysfunction.

If you experience erections that fade away soon or soft erections, consult your doctor for further evaluation.

How Is Venous Leak Diagnosed

A venous leak is suspected as a cause of erectile dysfunction in men who able to obtain erections but lose it very fast. Veno-occlusive insufficiency is also suspected .

A definitive diagnosis of corporo-venous occlusive erectile dysfunction is made using penile Doppler ultrasoundwith an intra-cavernosal injection of prostaglandin or Trimix. End-diastolic velocity, a parameter measured by duplex ultrasound, is typically greater than 5 mL/s in patients with a venous leak. Normally, EDV is less than 5.

It is important to understand that severe anxiety can produce false results. Similarly, an inadequate dose of Trimix or prostaglandin can suggest veno-occlusive insufficiency when the problem may be related to arterial insufficiency or combined problem. Redosing with a higher dose of Trimix or SuperTrimix is usually advisable when the diagnosis is uncertain.

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What Is A Venous Leak

Your must store blood to keep an erection. If the veins canât keep blood there during an erection, you’ll lose it. This is called venous leak. It may happen with PAD.

Itâs also linked to diabetes, Peyronie’s disease , some nerve conditions, and even severe anxiety.

Doctors treat it in much the same way they treat all PAD-related ED problems. Possibilities include:

  • Medications and lifestyle changes to treat underlying PAD.
  • Testosterone replacement therapy
  • Penile implants: Hydraulic pump, prosthesis, and others

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How To Cure Venous Leakage

How to treat Venous Leak and Erectile Dysfunction
  • Consult Cincinnatis Top Mens Clinic for a Venous Leakage Diagnosis and Treatment Options
  • Erectile dysfunction is the bane of any sexually active man. It can cause great distress to them and their partners, severely limiting the sexual component of a relationship.

    Erectile dysfunction, being a highly prevalent disease, can be classified under different subtypes. This is due to the multifactorial tendencies of this type of sexual dysfunction.

    One specific condition to be talked about in this article is venous leakage-related erectile dysfunction.

    Also known as venogenic erectile dysfunction or penile venous insufficiency, a venous leakage is one of the underlying reasons behind soft erections.

    The majority of affected men are either born with it or acquire it during their formative years. If left untreated, this ailment can persist for the rest of a mans life.

    Howeverwith the right treatmenterectile dysfunction caused by venous leakage is treatable. Heres more information about venous leakage and the treatment options you can get.

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    Does A Prostatectomy Cause Venous Leak

    Prostatectomy surgery usually results in temporary or permanent reduction of erectile function. Pubmed reports that nerve-related tissue damage resulting from the surgery may cause venous leak. The prevalence of venous leak has been found to correlate to whether the surgery was nerve-sparing, with bilateral nerve-sparing having the lowest incidence of venous leak, unilateral nerve-sparing having the next lowest incidence, and non nerve-sparing having the highest incidence of venous leak.

    Aging And Venous Leak

    Perhaps the most common cause of venous leak is normal aging. As mentioned previously , the valve that controls blood outflow is pressure-activated, meaning that the pressure of the erection closes the value. Two factors of old age make this mechanism less effective. The first factor is that the erection is not as hard as it used to be, so there’s not as much pressure closing the valve. The second factor is that the veins harden with age, so it takes more pressure to close the valve. It’s like the valve stiffens with age.

    So the erection is trying to close a stiffer valve, with less pressure. The valve doesn’t close off as well as it did when we were younger, resulting in venous leak.

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    Is Venous Leak Curable

    The current definitive cures for venous leak are ligation surgery, deep-penile-vein arterialization surgery, and surgery involving a combination of the two techniques. Ligation surgery involves ligature of selected blood veins to slow the venous leak. Arterialization surgery splices blood vessels between the arteries and veins so that blood can cross from arteries to veins and vice versa and so that pressure can be partially equalized between arteries and veins.

    Causes Of Venous Leakage


    Erectile dysfunction, which affects over 150 million men over the world, is caused by a myriad of factors. As such, treating erectile dysfunction is highly dependent on the cause.

    To diagnose venous leakage, doctors look for the following symptoms:

    • Testosterone deficiency
    • Side effects of certain medications

    The risk of venous leakage increases with pre-existing health conditions. Remember, you can avoid most health conditions by following a healthy diet andexercising regularly.

    Similarly, stress and psychological issues may also affect your sex life, causing psychogenic erectile dysfunction. A psychotherapist may be helpful if you suffer from such cases.

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    Antegrade Approach Via Deep Dorsal Penile Vein

    50-year old man with erectile dysfunction due to veno-occlusive disease. Contrast enhanced CT cavernosography demonstrates right sided venous leak via periprostatic veins . Cavernosography with access via the deep dorsal vein and injection of contrast medium demonstrates right sided venous leaks predominatentely via periprostatic veins . Post embolization of periprostatic veins using N-butyl-2-cyanoacrylate mixed with Lipiodol demonstrating radiopaque intravenous embolization material .

    Why Dont Drugs Or Injections Work

    Drugs and injections activate blood inflow. Think of drugs and injections as pumping more air into the tire. If there’s only a slow leak, then more pumping will keep the tire inflated. However as the leak gets worse, the tire goes soft or flat, even with a lot of pumping.

    Similarly with the erection, if there’s venous leak, the drugs and injections that activate blood inflow may not be sufficient to maintain the erection. The erection goes soft.

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    How Does Vascular Disease Affect Erectile Dysfunction

    Erectile dysfunction, or ED, is when a man is unable to get or maintain an erection firm enough for sexual relations.

    Vascular diseases are those that damage your blood vessels or change the way they work.

    One type of vascular disease, atherosclerosis, or âclogged arteries,â is a major physical cause of ED. Atherosclerosis is the buildup of cholesterol and fats into a sticky plaque that forms on artery walls.

    Atherosclerosis that causes ED is called peripheral artery disease, or PAD.

    Vascular diseases like PAD may be the cause of ED in as many as 50% to 70% of men who have it.

    Doppler Evaluation For Flaccid Erectile Dysfunction

    Gary found a solution for venous leakage condition

    Spectral Doppler US can be useful in the evaluation of patients who are unable to achieve an erection by screening for arterial insufficiency or venous leak. Serial interrogation of the cavernosal arteries is performed before and after the intracavernosal injection of prostaglandin. The presence of a tardus parvus waveform or a lack of change after injection, or both, suggest arterial insufficiency, in which case transcatheter intervention may be helpful in improving arterial inflow. More commonly, there is ineffective closure of the venous outflow, called a venous leak. With normal venous closure, loss of diastolic flow indicating high-resistance arterial flow occurs. With venous leak, only minimal decrease in diastolic flow 30 minutes after prostaglandin injection occurs.

    Peter Langenstroer, in, 2007

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    Why Does The Valve Stop Working

    There are several reasons the valve can stop working, but the most common reason is aging. The valve is pressure-activated, meaning that the pressure of the erection closes the value. Two factors of old age make this mechanism less effective. The first factor is that the erection is not as hard as it used to be, so there’s not as much pressure closing the valve. The second factor is that the veins harden with age, so it takes more pressure to close the valve. It’s like the valve stiffens with age.

    So the erection is trying to close a stiffer valve, with less pressure. The valve doesn’t close off as well as it did when we were younger, resulting in venous leak.

    What Is Venogenic Erectile Dysfunction

    Venogenic erectile dysfunction is the medical term for ED caused by venous leak.

    On the other hand, arteriogenic erectile dysfunction is the medical term for ED caused by insufficient blood inflow. Remember, blood flows in through arteries and out thorough veins.

    To summarize

    Arteriogenic ED = too little blood inflow through arteries.

    Venogenic ED = too much blood outflow through veins.

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    Venous Leak Treatment Without Surgery

    Venous Leak Treatment Without Surgery


    Venous Leak Treatment Without Surgery

    Venous Leak Treatment Without Surgery


    The device doesnt make use of air to create a vacuum cleaner, as a matter of fact, it relies upon the use of water to harness vacuum.

    All you are required to do is to spare some time as well as prepare yourself for an incredible sex-related experience with your partner. You can use this product in your shower.

    It takes just 15 mins for this device to assist you accomplish every little thing that you have actually been long yearning. Not just this, yet the manufacturers also claim that you could attain a penile length rise by 1-3 inches upon erection on the initial use of this item.

    Just How Bathmate HydroXtreme9 Functions?The functioning concept of Bathmate HydroXtreme9 is based on water-based vacuum pressure. Therefore, the makers have actually moved away from standard air-based pressure.


    The convenience pad that has actually been connected provides excellent support when you are attempting to keep a vacuum inside the pump.

    Because of this, the suction is improved as well as the contact in between you as well as the cyndrical tube is boosted.

    Venous Leak Treatment Without Surgery

    This was a maximum number for me that benefited me quite well.

    You can repeat this process every day in order to boost your sexual performance.


    I Think I Have Venous Leakage What Next

    Venous Insufficiency Treatment Tampa, FL (813) 377

    Maybe its time to receive some 1-on-1 guidance from a board-certified urologist. Why not start with a VirtuCare telemedicine consultation. Our experts can take a detailed history to see what the next best step is for you.

    If you need referral to an in-person urologist, then we can help guide you to a colleague with expertise in treating venous leakage. We have an extensive network and want you to get the best care possible.Stop struggling with venous leakage and get help today. and someone will reach out to you within 24 hours to schedule a virtual visit from home for only $89.

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    Does Enlarged Prostate Cause Venous Leak

    Men who have benign prostatic hyperplasia , a noncancerous enlargement of the prostate, may experience erectile dysfunction and ejaculatory problems.

    Although BPH does not itself cause these problems, some of the treatments used for BPH can do so. For example, finasteride , an anti-testosterone drug prescribed for BPH, has been linked to erectile dysfunction in 3.7% of men who use it and to diminished libido in 3.3%.

    On the other hand, alpha blockers such as tamsulosin, alfuzosin, and silodosin can improve the symptoms of BPH with a lower risk of sexual side effects.

    Transurethral resection of the prostate, a surgical technique often used when medication fails, also causes erectile dysfunction in a small percentage of men.

    Other Causes Of Venous Leakage

    The most common causes of arteriogenic ED are the same diseases that cause atherosclerosis or hardening of the arteries:

    Since atherosclerosis is so common as we age, most men with venous leakage also have some degree of an arteriogenic cause of ED. More importantly, atherosclerosis is the most common cause of heart attacks and strokes. So if your buddy aint performing, make certain you have an evaluation with your primary care doctor to check out your heart and blood vessels.

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    What Are The Risk Factors For Pad

    Some common risk factors include:

    • Increasing age, especially after 65
    • Family history of PAD, heart disease, or stroke
    • High blood levels of homocysteine, an amino acid that makes protein

    Youâre most likely to get PAD if you smoke or have diabetes. But any one of these factors makes it more likely that youâll get PAD that could cause erectile dysfunction.

    Our Approach To Erectile Dysfunction

    Treatment of erectile dysfunction caused by Venous leakage by interventional coil embolization

    UCSF is a national leader in treating urological disorders, including male sexual dysfunction, urinary incontinence, pelvic pain, urinary stone disease, male infertility and prostate disease. We offer the full array of therapies, including the latest techniques, and our team is committed to providing innovative, highly skilled care with compassion.

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    Drugs Or Injections Used To Work But They Dont Any More How Come

    Let’s go back to the tire example. If the pump used to work but now it doesn’t, what’s happening? Either the pump isn’t getting air in, or there’s a leaky valve .

    In the case of an erection, if drugs or injections used to work but now they don’t, it may be that the drugs or injections are not as effective at creating blood inflow. Or it may be that venous leak is starting to occur or getting worse, causing excess blood outflow.

    How Successful Is Venous Leak Surgery

    Venous leak surgery is not very successful.

    A PubMed article reports 49% success rate treating venous leak with ligation surgery. It also reports a growing preference for combination arterialization/ligation surgery over regular ligation surgery. However, another PubMed article reports a low success rate for arterialization surgery.

    Frontiers in Cardiovascular Medicine reports in one article that “Not very encouraging, long-term success rates of surgical ligation of the deep dorsal vein and its collaterals are reported to be approximately 25%”.

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    Surgical Treatment Of Venous Leakage: Medium

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    I Read That Xialla Can Be Used In Combination With Drugs Or Injections Please Explain


    Erectile dysfunction can be caused by too little blood inflow, too much blood outflow, or a combination of the two. In cases where the ED is caused by a combination of causes, it may require a combination of therapies to achieve successful results.

    Using a combination of therapies, drugs or injections are used to increase blood inflow while Xialla slows the blood outflow. The combination is proven to achieve excellent results in many cases.

    For more information on using Xialla with medications or injections, see this article.

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