constant stimulation required

[Pete28]

I have got ED for over a year now. And things progress to worsen.
I need to constantly stimulate my penis in order to keep it 80-90% erect. Sometimes i think i reach a fuller erection. But when i leave stimulation, it goes down within 5-10 seconds. It's always the same, stimulation ... gaining a little bit hardness ... bit softer again ... harder ... softer ... I can keep it going with massive concentration and constant stimulation. The erection process is like climbing a mountain with a heavy backpack. Cannot remember last time when i have had descent morning wood.
Last time i visited the uro he seemed to notice some hardning in my flaccid penis. It turtles a lot.

Do others regognize this type of condition? Is it venous leakage?

[Pete28]

Old Man


Thx for your answer. The problem is the following: last year i have had a Doppler and a MRI-scan (after injection of Caverject). My penis only went semihard. The uro told 'this is normal because it's only a chemical reaction without sexual stimulation and this was the reason full erection was not obtained'. According to him there was no venous leak. The semi-erection went away in about half an hour. This doesn't seem logical: how can you 'see' based on only a half erection if a man can obtain and maintain a full erection, how is this possible? This doesn't seem to make any scientific sense.

In the meantime my problem has worsened and the thing is, this uro is recommended as the best 'ED-specialist of neigboorhood, even of my country (Belgium)'. He is almost apathic about it, he thinks it's all in my mind and adrenaline. But i know my body best and it is not acting like it should.

Every additional advice would be very much appreciated.

[SSmithe]

Pete28,
Pete, I am 30 years old and have almost the exact same symptoms as you.  Constant stimulation is required to maintain an erection, and I have not had morning erections in over 5 years.  I too had only a semi-erection when injected with Caverject.  My URO doubted venous leakage as the semi-hard erection lasted for over an hour.  I needed an adrenaline shot to make it go away.
From what I understand about venous leakage, it is pressure that forces the veins closed and maintains blood in the penis.  Therefore, if an erections remains at lower pressure (semi- hard), it should remain when hard.  This makes me think venous leakage may not an issue.  This may apply to you.

I am going to be checked for possible artery damage due to mountain biking later this month.  My URO thinks this may be the cause.

My guess / fear is that the Peyronies Disease has hardened and removed the elasticity of the tunica.  This makes it more difficult to get erect as your penis doesn't want to expand... Like it squeezes the blood right back out, or prevents it from entering.

Keep us posted if you find anything out.  I will do the same.  Its one day at a time for me.
SSMithe

[skunkworks]

It is something that is not mentioned on these boards at all for whatever reason, but there are surgical treatments for venous leakage. Not very successful for the over 50 I am told, but for younger guys it can work very well. I personally know three people who have had their venous leakage treated successfully by an interventional radiologist, the most recent had his surgery in 07.

They go in and close or partially close the problem veins, either with a coil, or via vein embolization.

[skunkworks]

SKW:

Rats! No help for us older gents huh? Maybe someday.

Old Man

To be honest if your insurance would cover it I would give it a shot anyway. The worst that can happen is that it will revert back to how it was before.

Plus it is keyhole surgery, and done under local so you are in and out in hours rather than days.

[Pete28]

I had a Doppler the previuous week.

Doc gave me a shot but little to none response.

Diastolic flow velocity of more than 5 cm/s is suggestive of venous leak. I had diastolic end flow of 10 cm/s.

[aloneinthek]

The end diastolic velocity of 10cm/s is on the left or right side? or both?

[Pete28]

I don't know. He didn't say that.  

[Pete28]

Since the shot i received in the uro's office, to which i had no response whatsoever, my ED has worsened a lot within a very short period of time. I am unable to get any sort of erection. And i feel severe hardening in my left corpora.
Told this to the doc and he said this was impossible from just one shot.
He did say such severe ED soon or later leads to prothesis insertion.
I will choose for that option, am not gonna wait till 'maybe' within thirty years (then i am sixty) there will be a cure for this problem.

I just want to say this: don't want to 'minimize' Peyronies, but if 'just' have Peyronies without serious ED, be happy with what you've got, you are very lucky, i wished i was in that situation.

[jackp]

Pete28

Yes injections into the penis, even just one, can cause peyronies and corporal fibrosis.

In my case I was trying injections for ED with little to no help. All they did was cause corporal fibrosis and even more problems.

I opted for a penile implant 10/23/08 at Vanderbilt. Now a great hard, straight penis that is read any time. I even gained back over 1" due to the VED therapy before my implant and then the AMS 700 LGX. www.amslgx.com.

Read my history for the rest of the story. Any questions please free to contact me.

Jackp

[Pete28]

At the moment i feel COMPLETELY left in the dark about my condition.
I am a 30-year old man who is suffering from increasing ED for the past two years and who has consulted all the 'best' urologists of his country (Belgium).

I feel a noticable increased firmness at the base of the shaft and relative increased firmnes at mid shaft. Sometimes i feel a dull ache at the base, mostly after self stimulation.

I did perform some manual jelqing exercises in the beginning of the year (the worst choice i ever made in my life) and i 'think' this has made matters worse. (i did not experience any pain) Not immediately after i had done the exercises but three weeks / a month later i noticed the increased firmness in my flaccid penis and more severe ED. My penis feels noticable weaker at the base and takes a lot of manual stimulation to get some acceptable degree of hardness. The base doesn't seem to expand properly and the tissue feels raw / non elastic. Spontaneous erections are none existent, morning erections do occur but are very weak.

Multiple doctors have examined my flaccid penis, some say it feels completely normal, others say there is some increased stiffness but cannot confirm what is going and whether or not it is scar tissue or don't seem to be worried about it.

Doppler examination after injection of PGE1 (very low test dose) revaled no fibrosis or calcification but only produced the weakest response (i only got a flaccid penis with some engorgement) and venous leakage. Thereafter i had a cavernosogram and cavernosometry done, which should be the gold standard for the diagnosis of veno-occlussive ED (with 40 mm papaverine). Strange enough this examination was considered normal without any evidence of venous leakage and normal cavernosal pressures over a thirty-second period.
Doc said he was 100 % sure i did not have venous leakage but may have 'some issues with poor smooth muscle relaxation' (which is a very vague diagnosis for my part). At the moment i haven't been diagnosed with VL, Peyronies disease or corporal fibrosis. But i really have a gut feeling i might have some of these conditions developing.

The undecidedness and moreover sometimes rudeness of the doctors i visited makes me depressed.
Last urologist (regarded as a very 'specialized' ED doctor) i went to just explained to me how the erection mechanism works and which can be done to 'improve' it, namely Viagra, shots or implants. He couldn't tell me any more specialized advice. When i told about the increased firmness and ED he just aswered 'We cannot make you any younger, some guys simply get ED when they reached the age of 30.' When i told about the possible damage i had done when doing the exercises, he went very cynical: 'Why don't you counsel the guys at the jelqing forum about that?' When i asked about the effectivess of the VED treatment he aswered 'don't use that pump' without any further explaination why not. I would very much consider a long range VED-therapy course but i want to make 100 % sure i don't want to make matters worse. My family doctor is also very non empathic and tells me most of this is probably psychological: 'It's normal that an erection is not always very hard and all guys need a lot of stimulation, rockhard erections only exist in porn movies.' He also advised me to take 100 mg Viagra and then visite a prostitute, which is an idea i don't like.

At the moment i am taking 5 mg of Cialis daily together with L-arginine (3 000 mg daily) and vitamin E. This enables me to masturbate but i doubt it's strong enough for intercourse. It's still very 'floppy' and i only can maintain with constant stimulation. The best erection is with 100 mg Viagra, then i obtain an acceptable level of rigidity but it's still not the rockhard erection which is needed for succesful intercourse. I also have some fear for intercourse, because making love with a less rigid penis could be dangerous and result in further injury.

Do some forum members know good urologists who take a person seriously (in Europe or the US) and don't just prescribe Viagra and then leave you in the dark (if i would travel to the US it should be a very very good one)? Or can give me some effective advice?


Sincerely my thx for your reaction and some good advice.
Pete

[chiguy]

I am obviously no doctor but two things triggered in my mind. One, you said you were diagnosed with venous leakage. Try to pursue that angle with a doctor. Though you are already on viagra/cialis/levitra so maybe go back to the urologist and discuss this.

If everything else seemed normal, it might be mental. Talk to a doctor who can prescribe you some medication for this issue.

[LWillisjr]

Pete,

In Europe I believe male sexual specialist are referred to as Andrologists. Try looking for a good andrology clinic that specializes in male sexual functionality. I believe there is a well known one in Germany but can't recall the name at the moment.

Les

[Ben]

Pete,
I haven't got yet 30 yo and had the same condition. I had good results and now have morning erections (not long lasting but anyway...) with mid-term use of a penis stretch (fast size / andropenis). After 700 hours results are here.

I wasn't responding very much with viagra or penile shot (alprostadil) and was worried. My main idea was to have an implant but I managed to restore some functionnal erection with bathmate / stretcher / L-arginine over the last year.

For now you may try to give and receive pleasure with your girlfriend / wife experimenting other manners. Be creative, sexuality can still be a source of pleasure, whatever your actual condition.

Best regards,
Benoît

[BrooksBro]

Even with 100 mg Viagra, 3 g L-arginine, and testosterone over 800, I have weak erections.  The only way I can achieve and sustain an erection adequate for intercourse is with a vacuum pump and constriction band.  I am unable to determine how much if this is physiologic and how much psychologic.  The pump and band work every time, and it is only a slight inconvenience.  I am not a diabetic.

[skunkworks]

Even with 100 mg Viagra, 3 g L-arginine, and testosterone over 800, I have weak erections.  The only way I can achieve and sustain an erection adequate for intercourse is with a vacuum pump and constriction band.  I am unable to determine how much if this is physiologic and how much psychologic.  The pump and band work every time, and it is only a slight inconvenience.  I am not a diabetic.

Have you been diagnosed with venous leakage? That is what it sounds like.

[jackp]

Brooksbro

You have all the classic symptoms of venous leakage.

A lot of doctors now use symptoms to diagnose venous leakage and some still do a Color Doppler (ultrasound).

The best thing to do is find a Male Sexual Function Specialist, not a general practice urologist. These doctors are hard to find and a lot of major cities do not have one, so you may have to travel to get a good one.

Jackp

[chiguy]

If the erection pills do not work, what is used to treat venous leakage?

[BrooksBro]

You are right about the critical importance of finding the right urologist.  For the past year, (has it only been one year?) I have been seeing Dr. Larry Lipshultz, urology department head at Baylor College of Medicine in Houston.  His clinic is now doing the botox study, and probably many others.  There are several other men on this forum that are also seeing him.  I have the highest confidence in his experience and knowledge.  We have just not yet found the ideal treatments for my conditions.  I have another appointment next week.

Brooksbro

The best thing to do is find a Male Sexual Function Specialist, not a general practice urologist. These doctors are hard to find and a lot of major cities do not have one, so you may have to travel to get a good one.

Jackp

[BrooksBro]

Good news/bad news from my recent visit.  

The doc confirmed venous leakage was the likely cause of my weak erections.  He explained the peyronies plaque prevents the erectile tissue from expanding to passively compress the veins and trap the blood.  The arterial blood inflow is enhanced by Viagra and the other meds, but the outflow is more mechanical.  Venous leakage is present in about 15% of men with peyronies.  Short of removing the plaque or vascular reconstruction surgery, an external band appears to be a reasonable solution.  It is immediately available, and so far, it works every time.

We agreed to "temporarily" stop topical testosterone, since it does not appear to be doing all that much to enhance my viagra response for ED.  We will look at this again in a few months.

I am now on the tentative candidate list for the phase III Xiaflex study, subject to further screening (and my consent), once the Baylor Clinic in Houston receives their study medications.

[skunkworks]

Good news/bad news from my recent visit.  

The doc confirmed venous leakage was the likely cause of my weak erections.  He explained the peyronies plaque prevents the erectile tissue from expanding to passively compress the veins and trap the blood.  The arterial blood inflow is enhanced by Viagra and the other meds, but the outflow is more mechanical.  Venous leakage is present in about 15% of men with peyronies.  Short of removing the plaque or vascular reconstruction surgery, an external band appears to be a reasonable solution.  It is immediately available, and so far, it works every time.

We agreed to "temporarily" stop topical testosterone, since it does not appear to be doing all that much to enhance my viagra response for ED.  We will look at this again in a few months.

I am now on the tentative candidate list for the phase III Xiaflex study, subject to further screening (and my consent), once the Baylor Clinic in Houston receives their study medications.

There are legitimate treatments for venous leakage beyond cock rings. This is on the St Vincents (very respected Aus hospital) Interventional radiology page.

https://exwwwsvh.stvincents.com.au/index.php?option=com_content&task=view&id=670&Itemid=721#Sexual%20dysfunction

[BrooksBro]

Thanks for the link. Placing blocks into the leaking veins is vascular surgery IMO. For me, any type of surgery is the very last resort. I'm not nearly there yet. If I get into the Xiaflex phase III study, I hope I get the real med and not the placebo.

Good news/bad news from my recent visit.  

The doc confirmed venous leakage was the likely cause of my weak erections.  He explained the peyronies plaque prevents the erectile tissue from expanding to passively compress the veins and trap the blood.  The arterial blood inflow is enhanced by Viagra and the other meds, but the outflow is more mechanical.  Venous leakage is present in about 15% of men with peyronies.  Short of removing the plaque or vascular reconstruction surgery, an external band appears to be a reasonable solution.  It is immediately available, and so far, it works every time.

There are legitimate treatments for venous leakage beyond cock rings. This is on the St Vincents (very respected Aus hospital) Interventional radiology page.

https://exwwwsvh.stvincents.com.au/index.php?option=com_content&task=view&id=670&Itemid=721#Sexual%20dysfunction

[Noway]

If your worried about not having hard erections for sex don't do the girl on top and you should be fine. Me too I have floppy erections and constant stimulation very discouraging.

[shrunken_dick]

Any update Pete? I am in the same condition.  

[Pfract]

Why would somebody expect a reply on a thread which is 10 years old, is beyond me. Good luck waiting for a reply.