Venous leak , also called venogenic erectile dysfunction and penile venous insufficiency , is one category of vasculogenic impotence -a cause of erectile dysfunction in males. The prevalence of the condition is still unknown, although some sources claim it to be a common cause of erectile dysfunction. Many men with Venogenic Erectile Dysfunction start having trouble with their erections from a young age. Physicians often look for signs that suggest an organic cause of erectile dysfunction rather than a psycho-osmotic cause in making a diagnosis of Venous Leak. Such suggestive signs include 1 Erectile Dysfunction that is persistent on all occasions where an erection is required, including with a partner and without a partner during masturbation, 2 Loss of quality of morning Erections, 3 Loss of quality of spontaneous erections, and 4 multi-treatment resistance to traditional erectile dysfunction medications including sildenafil and cavernosal injection therapy.
For more information, please see Oral Medications for Erectile Dysfunction. The medication helps increase blood flow to the penis. Aversa A, Sarteschi LM. Tteat Herwig R Erectile dysfunction and caverno-venous leak disease. Interestingly, venous leak disease as cause for erectile dysfunction is, in no case, only a condition found in human.
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In a normal male, Erectile disfunction venus leak treat inflow of blood expands the spongy tissue in the penis. The suppository is then absorbed and helps to produce an erection. Your Endothelial analysis will provide a detailed analysis of your blood flow rates throughout your body. Operation time ranged from 2. When Ass goo girl man is sexually stimulated, chemicals like nitric oxide are released Erectile disfunction venus leak treat the nerve terminals, which cause the penile smooth muscles to relax, helping to foster an erection. It's anywhere, Free hardcore x warez health on our minds. Whereas the current treatment strategies are mostly focused on older men, young patients are seeking more for a longer lasting or definitive solution, rather than a life-long medical treatment. Most recently an article on the outcome of crural ligation for isolated crural venous leakage in 14 young patients was published by a study group from the Memorial Sloan Kettering Cancer Center and Columbia University . This — is what we do: its our specialty. These images can help a doctor determine how to treat the condition. What is the Connection Between Smoking and Impotence? The choice of operation offered should be decided on available wisdom and infrastructure, the experience and preference of the operating surgeon, and the basis of the site, nature, and size of the leak . If baking without baking powder interests you, then you will be a permanent visitor here, for we think, live, and eat healthy and primarily focus on baking without baking powder or soda. The major advantage of the therapy is that is applied locally by patients or their partners, and has few side effects.
Sexuality is an important part of the human experience, which is why a diagnosis of erectile dysfunction ED can be troubling for men and many couples.
- Are you one of the millions of guys affected by Erectile Dysfunction?
- Problems with blood vessels are a common cause of erectile dysfunction ED.
- There are a variety of treatment options available for erectile dysfunction, which will be explained to you by your doctor.
- Learn something new every day More Info
How to avoid the false diagnosis of venous leakage by pharmaco-penile duplex ultrasonography? Abd Allah M. Objectives The aim of the present study to carefully reassess the erectile hemodynamic status in men previously diagnosed with venous leak on penile duplex ultrasonography DUS under the guidelines of the Australasian Society for Ultrasound in Medicine ASUM.
Vascular insufficiency is one of the major causes of ED. DUS is a useful, minimally invasive method for evaluating penile hemodynamics in patients with ED, but has a propensity to inaccurately assign a diagnosis of venous leak. Patients and methods Fifty patients from 18 to 50 years olds selected from the Andrology Unit, Dermatology and Andrology Department, Faculty of Medicine, Menoufia University, Egypt were included in the study.
All cases were subjected to the following: detailed history, thorough clinical examination, routine and hormonal investigations, and imaging studies including re-evaluation through DUS under the guidelines of ASUM. The study demonstrated a significant increase in the value of peak systolic velocity in repeated DUS with a mean difference of Our results indicated a significant negative correlation between age and value of peak systolic velocity, and an insignificant positive correlation between age and value of EDV for all participants, in both original and repeated DUS.
Conclusion Careful assessment should be carried out when performing DUS, especially in younger men without a significant vascular risk factor in history for ED, to avoid misdiagnosis of venous leak. Users Online: Evaluation of young men with organic erectile dysfunction. Asian J Androl ; 17 — Erectile dysfunction in chronic kidney disease: from pathophysiology to management.
World J Nephrol ; 4 — The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med ; — Do men with mild erectile dysfunction have the same risk factors as the general erectile dysfunction clinical trial population? BJU Int ; — Campbell-walsh urology. ISBN Philadelphia: Saunders Elsevier; Diagnosis and treatment of erectile dysfunction — a pratical update. J Med Life ; 2 — Ludwig W, Phillips M.
Organic causes of erectile dysfunction in men under Urol Int ; 92 :1—6. Testosterone in type II diabetic men. Menouf Med J ; 27 — The link between vasculogenic erectile dysfunction, coronary artery disease, and peripheral artery disease. Role of metabolic factors and endovascular therapy.
J Invasive Cardiol ; 25 — Evaluation of penile perfusion by color-coded duplex sonography in the management of erectile dysfunction. World J Urol ; 22 — Ghanem H, Shamloul R. An evidence-based perspective to commonly performed erectile dysfunction investigations. J Sex Med ; 5 — Mulhall JP. The false diagnosis of venous leak: prevalence and predictors. J Sex Med ; 8 — Aversa A, Sarteschi LM. The role of penile color-duplex ultrasound for the evaluation of erectile dysfunction.
J Sex Med ; 4 — Anxiety-induced failure in erectile response to intracorporeal prostaglandin-E1 in non-organic male impotence: a new diagnostic approach. Int J Androl ; 19 — Erectile dysfunction: the role of penile Doppler ultrasound in diagnosis. Abdom Imaging ; 34 — Variation in penile hemodynamics by anatomic location of cavernosal artery imaging in penile duplex doppler ultrasound.
J Sex Med ; 12 — Phentolamine re-dosing during penile dynamic colour Doppler ultrasound: a practical method to abolish a false diagnosis of venous leakage in patients with erectile dysfunction.
Br J Radiol ; 77 — Evaluation of vasculogenic impotence. Urol Clin North Am ; 15 — McMahon CG. Comparison of the response to the intracavernosal injection of a combination of papaverine and phentolamine, prostaglandin El alone and a combination of all three in the management of impotence. Int J Impotence Res ; 3 — Cavernosometry: is it a dinosaur?
Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol ; 57 — How to cite this article: M. How to avoid the false diagnosis of venous leakage by pharmaco-penile duplex ultrasonography?. Menoufia Med J ; How to cite this URL: M. Click here to view. DUS, duplex ultrasonography. Figure 4: Correlation between age and original duplex ultrasonography without guidelines for the total sample.
Figure 5: Correlation between age and repeat duplex ultrasonography with guidelines for the total sample. Search Pubmed for M. Search in Google Scholar for M. Related articles Australasian Society for Ultrasound in Medicine duplex ultrasonography erectile dysfunction. Access Statistics. Sitemap What's New Feedback Disclaimer.
The superior visualization of the complex venous draining system in a 3D-CT cavernosography before Figure 1 and after sclerotherapy Figure 2 was first described by Virag  and could be verified by Uhl  and Xu . In a further study from Chen a highly significant change in IIEF score after long-term observation was stated for patients who underwent deep dorsal vein stripping . We can get your penis working better ASAP — but unlike others — we can also heal the underlying problem without dependence on drugs, injection or surgery over time. Serefoglu, Ege Can, et al. It also is important to note that after inserting the suppository into the penile uretha, sexual stimulation is required to increase blood flow to the penis. It is important to note that all oral medications for ED must be followed by sexual stimulation in order to achieve the desired erection.
Erectile disfunction venus leak treat. Primary Sidebar
Morganstern has developed, tested and refined the next generation of treatment for men suffering from chronic ED. Ten years ago, erectile dysfunction was a hush-hush subject you rarely heard anyone discuss openly. Following the introduction of Viagra, Cialis and Levitra? All three medications helped lots of guys attain an erection firm enough for healthy intercourse. Success from PDE-5 inhibitors like Viagra and Cialis is limited for men with vascular problems or heart disease.
Urology world provided other options: vacuum pumps, penile bands and penile injection therapy. Up until now — a penile implant — or penile prosthesis — was the only additional option available to such patients. There are basically two types of penile implants: semi-rigid and inflatable devices. The semi-rigid version is a set of rods implanted into the penis that can be bent as needed for optional penetration.
Their big downside? They always stay rigid making their existence difficult to conceal. The inflatable implants are more popular since they look more natural. The device is inflated by squeezing the pump several times to transfer fluid from the reservoir to the chambers in the penis.
After successful sexual relations, the pump can be deactivated to return the penis to a flaccid condition. Almost all implanted penile prosthesis devices perform satisfactorily for a decade or more before needing replacement.
Best of all? Its non-invasive: no surgery required. Our founding physician: Steven L.. Morganstern, MD was at the forefront of their launch in — as the national head of physician implant training for first-inventor Brantley Scott.
Morganstern played a big role in driving market acceptance amongst physicians and also personally performed over 4, Penile Implant surgeries.
The technology was game-changing — providing a viable solution for a lifetime of sexual performance with patients suffering from chronic ED. Erectile Dysfunction Treatments. Nervous to talk about your ED? How do I perform intracavernosal injection therapy treatments at home? Importantly: Approximately 30 million men in the US alone — including over half of guys between 40 and 70 years of age suffer from Erectile Dysfunction symptoms.
Erectile dysfunction ED is not in itself a diagnosis. Rather, its most often a symptom of another health concern. In most situations? Inquire about Erectile Dysfunction Treatment. Thus, all the treatments in the world focused upon their penile area prove ineffective.
ECP fixes those issues. We utilize Low Intensity Shockwave treatments which were recently discovered to cause stem cell regeneration in the penile region. We were utilizing this modalities an aspect of healing ED long before Dr.
We perform our proprietary Endostimulation treatments directly into the penile tissue. These applications cause the penile tissue to draw an influx of Oxygen — promoting renewed tissue development.
How Do We Do It? Most Comprehensive Blood Testing Every doctor takes your blood; it provides the clearest immediate roadmap about what ails you beyond what you can verbalize. Proprietary Vascular Analysis We provide a unique and detailed Doppler ultrasound of your penis to unlock the keys to healing within your groin plus we perform an endothelial test to evaluate healthy blood flow throughout the rest of your body.
This test will illuminate the status of the four essential aspects of a healthy penis: Blood Flowing Through the Penis We will be looking at how the blood flows through the penis and how quickly, or: peak systolic velocity. Penile Blood Retention: Retaining Erections After all that blood pumps into your penis: we need it to stay there in order to maintain your best erection.
What is Venous Leakage? Penis Blood Storage: Veins Your penis must store blood in order to maintain a rigid erection. The Process of a Healthy Erection Your penis is made of three tubes. What Causes a Venous Leak? Type II Diabetes A problematic vascular health issue can trigger early age disruption in penis muscular function.
Penis Plaque Build Up Built-up plaque is a common challenge in penile health. Endothelial Testing: Blood Flow Analysis Your Endothelial analysis will provide a detailed analysis of your blood flow rates throughout your body.
Custom Patient Erectile Scorecard After your review of findings with our skilled urologist, our clinical director will sit down and share our proprietary point patient scorecard that exhibits all your various results, how they far against the norm of other men your same age — and what we can do to overcome any deficiencies. Your treatment plan is custom to you and your personal sexual health. The best news? Its all non-invasive: no surgery is required.
ED Goes Mainstream Ten years ago, erectile dysfunction was a hush-hush subject you rarely heard anyone discuss openly. Penile Implant: What is it? If you reach down and pull your penis taught with your fingers?
Masturbation can be painful Surgery down time: weeks. At that time? But that was Founding physician and best-selling author Dr. Steven L. Morganstern was on the forefront of men's sexual health long before others even talked about it - he continues to transform treatment solutions that change the industry and improve patient outcomes. Morganstern Urology, P. Patient Portal. Vascular shunts can be located as cause of erectile dysfunction by serial contrast radiography of the corpus cavernosum penis.
The only in this context cited article in the EAU guidelines 3 is from the group of Wespes . Unfortunately, this article is not qualified to substantiate such a statement. Of patients with vascular erectile dysfunction who underwent various surgical procedures, only 11 patients were treated with venous resection.
For further evaluation, only 7 patients were eligible after 48 months in this group of which only one patient reported about sexual satisfaction. A reliable guideline statement about the successfullness of this intervention can not be seriously made from this number of patients with this evaluation method. The authors assert, that this finding is evidence enough to recommend penile revascularisation for young patients with traumatic arterial lesions .
This statement was adopted into this guideline version, too. Another, more serious study was performed earlier in the by Popken et al. In this evaluation ligature and resection of the superficial and deep veins of the penis DPVL was performed in patients. All patients were non-responders to intracavernosal injection of alprostadil SKAT , which is a very difficult initial starting point to prove the effectiveness of such a procedure.
In a third of the patients natural erections could be regained and maintained for a long time. This is an important aspect, because in many countries penile implants are not covered by insurance companies and therefore most of these patients can not afford this expansive therapy option. In the most recent guidelines of the EAU from  the afore mentioned literature citation is replaced by a Meta-Analysis of Sohn et al.
Furthermore, the literature processed in this publication of Sohn et al. The members of the 3rd International Consultation on Sexual Medicine in Paris published their conclusions and recommendations in two recent articles in [28, 29].
In this context, a compilation of outcome data of simple ligation techniques published until was discussed . In the here revised literature a wide variety of success rates was found.
For the authors, no single operative technique seemed to be superior to others, and a steep decline of success has to be noted with length of follow-up in single ligation procedures.
But, the authors stated, that young patients with site-specific congenital, posttraumatic or post-inflammatory leaks may be considered for vein ligation with informed consent.
The choice of operation offered should be decided on available wisdom and infrastructure, the experience and preference of the operating surgeon, and the basis of the site, nature, and size of the leak . In contrast to these ancient findings, various modified and improved technologies with much better short- and long-term outcome have been recently described.
The first report of arterialization of the deep dorsal vein was published in by Virag et al. Due to the fact, that more recent literature dealing with new concepts of minimal invasive technologies and modern diagnostic tools our aim was to present an overview over the results from this more recent studies.
A structured review of English-language articles on PubMed published till coupled with examination of tables of contents of high-impact journals to identify articles related to venous leak treatment was performed. These articles were appraised for their importance to medicine. Current publications explored, that 3D-CT cavernosography can provide high-resolution images of venous drainage from any angle. Therefore, the authors conclude that the images obtained by 3D-CT cavernosography are very helpful for both the diagnosis of corporal veno-occlusive dysfunction and the anatomical study of the human penile venous system and may lead to better strategies in venous leak treatment [17—21].
Interrestingly, penile venous surgery with ligation of the crura for venous leakage has revealed good long term results and high patient satisfaction.
The unanimously stated conclusion from these studies is, that this technique should be offered in young men with primary cavernosal erectile dysfunction. Young patients with normal penile arterial system and no risk factors such as diabetes had the best chance to improve erection and have a good postoperative success [22—27].
From on to the present time, several further publications on minimal invasive venous leak procedures for ED have been published. Basche et al. At one year follow up all patients treated still achieved spontaneous erections without any additional medical treatment . Cayan et al. Mean postoperative follow-up was IIEF-5 score rose statistically significant from 6.
Hsu and coworkers described a venous stripping procedure in selected patients with isolated CVOD excluding untreated systemic disease. Of patients patients were submitted to this procedure and further were left without surgery .
IIEF-5 score increased from 9. Operation time ranged from 2. All these publications denied serious complications, as well as penile shortening or loss of sensation. Most recently an article on the outcome of crural ligation for isolated crural venous leakage in 14 young patients was published by a study group from the Memorial Sloan Kettering Cancer Center and Columbia University . The IIEF score was raised from 18 to 24 after 1 year of follow-up.
Seventy-one percent experienced unassisted post-operative sexual intercourse. The authors conclude that crural ligation may be a promising approach in those rare young patients with primary venogenic ED and isolated crural leakage.
Vale et al. In a further study from Chen a highly significant change in IIEF score after long-term observation was stated for patients who underwent deep dorsal vein stripping . A further newly described method is the embolisation technique. During this aproach, either antegrade or retrograde venous closure can be performed [30, ]. Table 1. Literature of embolisation technique used in treatment of erectile dysfunction 17, 22, 30, 32, , 41, 47, 52, Unlike in urology, in general surgery, there are clear guidelines for the treatment of varicous veins .
The reason is lying in the mode of action in these agents. The longer and concentrated the substance can stay at the venous wall, the more effective is the sclerosing action of the medication. If applied as microfoam, it can be even more effective, due to better visibility under X-ray and more homogeneous contact to the endothelium . The superior visualization of the complex venous draining system in a 3D-CT cavernosography before Figure 1 and after sclerotherapy Figure 2 was first described by Virag  and could be verified by Uhl  and Xu .
The picture in figure 1 describes the complex situation in venous leakage disease and the need for a more complex renovation of the situation. It might also explain the fact, that neither simple ligation of penile veins, nor ligation of crural veins could sustainly solve the problem of venous leak disease. Furthermore, these pictures might reveal the up to now unexplained relation between erectile dysfunction and hemorrhoids  and possible erectile dysfunction after hemorrhoid sclerotherapy , due to the fact that the related veins are connected via the deep pelvic vein system.
These results also demonstrate the urgent need to re-explore the veinous drainage system with new higher sophisticated techniques. Figure 1. The superior visualization of the complex venous draining system in a 3D-CT cavernosography before sclerotherapy.
Therefore, this in many cases underlying combination of cavernosal and crural insufficiency should be addressed in one procedure to prevent early relapse . In a very recent study of Herwig and Sansalone these aspects are respected in a newly described technique, which reaches the deep dorsal vein system, as well as the crural venous system [17, 46, 47]. When preparing the deep dorsal vein at the proximal penis shaft, the ligation of the vein distally closes the primary leak from the deep dorsal vein.
In addition, the afore localized major leakage point revealed by 3D-CT cavernosography can be closed by several distal and proximal ligations. Afterwards, a 5F-Angiokatheter is placed in the proximal part oft he vein.
Under Valsalva-Maneuver, which has to be performed by the patients, the blood flow is reduced in the lower pelvis equal to the compression described in general surgery guidelines.
When injecting polidocanol as a sclerosing agent during this time, the agent can stay longer at the venous wall and the effect of the sclerosing therapy is maximized. No residual crural or deep dorsal vein leakage could be detected after integrate combined ligation of the deep dorsal vein and antergrade sclerotherapy procedure Figure 2. Therefore, this method is providing a therapy for deep dorsal vein and crural venous leakage in a minimal invasive setting at the same time [17, 46, 47].
Figure 2. The superior visualization of the complex venous draining system in a 3D-CT cavernosography after sclerotherapy. With this newly described technique, at 3 month follow-up 77 out of 96 patients Four 4. Follow up with color Doppler ultrasound and CT Cavernosography revealed a new or persistent venous leakage in 8 8. Four As before, the authors denied serious complications.
These data have been supported by a report of Carrino et al. These recent good results with this technique lead Rebonato et al. Although the technique is not always successful restoring completely the erectile function, in most cases, the patients have a satisfactory erectile function just resorting to oral pharmacotherapy PDE5 inhibitors , delaying the time to penile prosthesis.
Although further exploration in randomized controlled studies is needed, these results should lead to re-consider venous leakage treatment with these minimal invasive methods in therapy of erectile dysfunction. The described methods are minimally invasive, are carried out in local anesthesia and do not contain major risks or complications.
Possibly, a combined therapy model is needed to support these mostly young patients and prevent them at least partially from life-long continuous medical treatment with all described disadvantages and complications. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Herwig R Erectile dysfunction and caverno-venous leak disease.
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Erectile Dysfunction Treatment | Conditions & Treatments | UCSF Medical Center
Sexuality is an important part of the human experience, which is why a diagnosis of erectile dysfunction ED can be troubling for men and many couples. The good news is that there are many options to consider. ED, or impotence, is the inability to achieve or sustain an erection long enough for sexual intercourse. While the condition most commonly affects older men more than 50 percent of men over 40 have ED , it can occur at any age.
Certain medical conditions can cause ED, including hypertension, diabetes, high cholesterol, coronary artery disease and peripheral artery disease. According to Dr. Foster, these disease processes can damage blood vessels in the penis. Here is how it works: When a man is sexually stimulated, the smooth muscle located inside blood vessels should relax, or dilate. This allows blood to flow into the corpora cavernosa, which are cylinder-shaped erectile bodies in the penis.
The result is an erection. Other reasons for ED can include smoking, taking certain prescription antihypertensive or antidepressant medications, prostate removal surgery or nerve damage from a spinal cord injury. Low testosterone can affect sexual interest or libido, but it may also affect erection quality. Doctors often prescribe oral medications phosphodiesterase type 5 inhibitors as the first-line treatment for ED. Viagra sildenafil , Levitra vardenafil , Stendra avanafil and Cialis tadalafil work within 30 to 60 minutes and their effects last for between 4 and 8 hours for Viagra, Levitra and Stendra or 36 hours for Cialis.
These medications act as a smooth muscle relaxant, allowing increased blood flow to the penis when a man is sexually stimulated. Although oral ED medications are estimated help 70 percent of men who try them, some may require a stronger dose of medication than is available orally. A urologist may recommend a medication that is delivered directly to the penis through injection therapy.
The doses can be increased, as needed, by your doctor. Injection therapy is FDA-approved for erectile dysfunction. The man injects a prescription medication alprostadil or papaverine into the side of the penis where, Dr. The medication helps increase blood flow to the penis. The man or his partner inserts the thin applicator a centimeter into the urethra and injects a pellet-sized bead of alprostadil. The medication dissolves and dilates blood vessels in the penis. A vacuum device does not involve medication.
It is, however, more cumbersome and less discrete. A man or his partner places it over his flaccid penis. It creates negative pressure to draw blood into the penis to create an erection, explains Dr.
A ring then needs to be placed at the base of the penis to keep blood within the erectile bodies; once removed, the erection will subside. How long does an erection last?
An erection may last more than an hour; however, to minimize the risk of penile injury, the ring should be removed within one hour. When other methods are not working, your urologist may suggest a penile implant, which is an outpatient procedure—you can go home the same day. Honig, because this option can restore spontaneity and is reliable in most cases, the patient satisfaction rate is high.
As with any surgery, there are risks such as the chance of infection, but there is another factor men need to consider. During the surgery, which takes about an hour, the doctor makes an incision in the scrotum, or base of the penis, and measures the appropriate implant length.
The urologist then installs the device usually an inflatable implant that sits inside the scrotum, plus a reservoir that holds the fluid salt water solution in the lower abdomen. The fluid functions like blood flow, filling the erectile bodies.
How long until it takes effect? Following surgery, men can resume sexual activity within six weeks. There are no time limits. In the end, which—if any— erectile dysfunction solution you choose depends on the right method for you.
Or, to make an appointment, call Erectile Dysfunction Causes Certain medical conditions can cause ED, including hypertension, diabetes, high cholesterol, coronary artery disease and peripheral artery disease. Standard Erectile Dysfunction Treatment Doctors often prescribe oral medications phosphodiesterase type 5 inhibitors as the first-line treatment for ED.
Additional Erectile Dysfunction Solutions Injection therapy for erectile dysfunction A urologist may recommend a medication that is delivered directly to the penis through injection therapy. Penile implant surgery for erectile dysfunction When other methods are not working, your urologist may suggest a penile implant, which is an outpatient procedure—you can go home the same day. Related Doctors. Call for an appointment. Penile Implant Prosthesis. The penile implant allows men to achieve an erection through an implanted device.
These devices can be effective in restoring sexual activity for a man and his partner. At Yale Medicine, our doctors have specialized experience with placing the penile prosthesis. Erectile Dysfunction. Erectile dysfunction or impotence, is a common, highly treatable condition. Often a physical problem, it also can affect men psychologically. Related Stories. Which Specialist Do I Need?