Originally Posted by Josh 14-11
Thanks for the clarification; I take it that the “tie-off procedure” was a venous litigation. Glad you didn’t have to to that!…Am I overstating it to say that “venous outflow” only becomes “venous leak” when there is corresponding “arterial insufficiency?” The Merck article does go on to say that “Venous leakage (excessive venous outflow due to inadequate compression of the venous drainage of the corpora cavernosa) also is common with aging.” They don’t describe how “aging” affects “compression,” but if there’s sufficient arterial blood supply, there should be adequate compression within the tunica. Unless there’s a Peyronie’s problem, or a kink (which I happen to have). Even then, we know guys with a kink or even full-blown Peyronie’s may not have a “venous leak” problem until penile arteriosclerosis or other gunk starts to accumulate—and the arterial inflow is cut back.
I am glad I didn’t need it, too.
You are overstating it somewhat on the “arterial insufficiency” side. A man with venous leakage does not necessarily have arterial insufficiency. His arterial flow may have always been adequate to provide for very firm erections, but now there enters a new wrinkle: his veins are directing the blood flow out faster than they should for some reason. His arterial flow is still fine but his venous flow is too rapid to sustain or sometimes even get a full erection. Is this a compression factor (compression being a key to preventing venous flow out?) or something else? There are easy tests which can reveal that.
In the field of ED, “venous leakage” is a very convenient sort of catch-all as a reason for erection loss, both for the male with the ED and for doctors who might prefer to prescribe one of the numerous erectile drugs rather than order a test to investigate, which might lead to the surgical route. There are doctors who can figure out that the issue is venous leakage based only on patient questioning, however to assess the damage and degree, a test is necessary.
My take is that you may have assumed you have venous leakage when in fact you may not and are concerned about something that has been in no way confirmed. This could lead you down a blind alley and waste your time.
In some cases of ED it is important to Know Your Enemy, to know specifically what you are dealing with. In others it is not. Guys with hormonal imbalances need to know. Guys with severe venous leakage, for another of several examples, need to know because the “fix” in their cases is more complicated than just taking drugs to get hard.
My advice? If the drugs are ineffective or inconsistant in resolving the problem, find a doctor who has a special interest in ED who will do more than hand you some samples and pat you on the back; someone whose curiosity is more a match to your own so that the two of you can identify the issue and then take proper steps to treat it.