Erectile dysfunction: what is a venous leak

Within the number of patient profiles that approach Andromedi Sevilla for erectile dysfunction, cases with venous leakage have historically been shown to be the most complex in terms of diagnosis and treatment. However, thanks to the technological revolution, both the diagnosis and treatment of this disease have improved.

What is venous leakage and why does it occur?

Men suffering from male impotence (also called erectile dysfunction) can be classified into four main groups according to their causative nature: psychological, hormonal, pharmacological and/or vascular. In this case, venous leakage would fall into the latter group, as it is described primarily as a physiological problem. Anonymously, they are very hard cases, since for example we can talk about young patients who may have a severe dysfunction that prevents them from maintaining a normal sexual life.

To understand what it is and why this ailment appears, first of all it must be remembered how an erection is produced: once sexual arousal has occurred, the circulatory and nervous systems increase their activity. The blood vessels bring blood to the penis, and the sinusoidal spaces “squeeze” the veins to maintain the hardness of the erection. It is at this point that, in some men, the so-called venous leakage or failure of the corporo-veno-occlusive mechanism occurs. Thus, the erection is lost partially or completely, since the blood escapes for physical reasons and does not achieve the necessary rigidity.

This dysfunction can have several causes:

  • Congenital origin, i.e. from birth.
  • It can appear after a severe trauma
  • Different pathologies affecting the circulatory system.
  • An abusive use of the so-called penis enlargers without a correct medical supervision or a bad execution of exercises of pedicle manipulation, that is to say, penis enlargement massages, known as Jelquing.
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How is venous leakage diagnosed?

Traditionally, a venous leak has never been easy to treat. The main reason has been the diagnostic system that has been used to date, as it was insufficient to identify the affected vessels. In recent years, the trend has changed, increasing in our practice the number of interventions by up to 60%.

In first consultations, Doppler ultrasound is a useful tool to identify the possibilities of the patient suffering from venous leakage, but it is in the second instance, when it comes to identifying the specific vessels, where the problem really lies. In the past, cavernosography and cavernosometry were used, although they did not reach the necessary level of detail. Today, we have a state-of-the-art diagnostic technique: multi-detector CT angiography with 3D reconstruction, which allows exact definition of the specific veins susceptible to ligation.

Thanks to this CT, surgeries have a high probability of success. On the other hand, there are also profiles in which the solution involves a prosthesis, since surgery would not be successful or safe.

Making a rough estimate, three out of ten people may benefit from surgery, whether its objective is to solve the pathology or to delay the use of the prosthesis.

As such, CT is not painful, and it is also quite fast, lasting between 0 and 40 minutes, without the need for hospitalization. In addition, it is able to diagnose effusion in all types of venous leakage.

Venous leak treatment and solutions

There are two possible solutions to venous leakage, depending on the results shown by the angio CT tests.

  • If it is considered that surgery will be simple and safe, and will restore the ability to maintain an erection safely, it is chosen.
  • If the CT angiography shows that there is too much damage, the penile prosthesis is then chosen so that the patient can recover his sexual life as soon as possible without having to undergo surgery several times.
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Surgical treatment of venous leakage is more economical than the implantation of a penile prosthesis, since in the latter it is necessary to pay for the prosthesis implant material.

In any case, Andromedi’s goal is always to restore the patient’s erection.