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[Asdf1234]

I went for a repeat Doppler today after the first one suggested I had venous leak on the left side. Today they done another Doppler with a stronger injection on the left side and the doc said that it was normal and no venous leak with good arterial inflow. I asked about Peyronies and he told me that there are no plaques or scar tissue and they would be able to see that from the scan so said that I don’t need to worry about Peyronies.

The trouble is I still find it hard to maintain an erection especially when standing? I get morning wood sometimes but as soon as I stand up it disappears. I also think my sex drive isn’t what it used to be. If the doc says no venous leak and no Peyronies then what else can be causing this?

[TonySa]

I’d consider 2.5 - 5 mg generic cialis nightly for at least 6. months.  It should give you strong erections and over 6 months may even reverse your Erectile Dysfunction.

[Asdf1234]

Thanks for your reply. I’ve been on Cialis 5mg for the last couple of months. They help a bit but still problems when standing. It leads me to think the problem I have must be psychological. They told me yesterday that my pulse was all over the place and I have ectopic beats. I do suffer from severe anxiety and depression

[TonySa]

Depression and anxiety can certainly aggravate Erectile Dysfunction.  Are you getting counseling or taking any medication for that?

[Asdf1234]

No, I’m not on any medication but am seeing a psychotherapist and started exercise it helps a lot. But have always got this nagging feeling that something is physically wrong downstairs. I have seen different urologists one says it’s all psychological the other says there’s always a physical cause so I just don’t know what to believe any more? I don’t get how they can tell me I have venous leak then a couple months later say I’m ok? No Peyronies either and just a congenital curve apparently. Feels like I’m back to square one. I just want to get to bottom of it all.

[TonySa]

Keep up the psychotherapy and exercise!  Try to remind yourself it’s a cogenital curve and u don’t have to worry about Peyronie’s.  Meanwhile if you also need it consider upping your nightly cialis dose or adding 100-200mg viagra before sex for solid erections.  Good luck guy and try to enjoy your disease free penis.

[Asdf1234]

Thanks, can I just ask though if Peyronies would always show on a Doppler,? It’s just that the appearance seems differnt as if it’s got shorter and narrower

[TonySa]

It usually will, especially if you have someone experienced in Peyronie’s.

[Asdf1234]

Ok, well I just hope he’s got it right. He assured me he would be able to see it..The other thing I’m finding very hard to understand is that it’s impossible for me to get an erection whilst standing up. Like literally nothing no matter how hard I try.. also when I’m having sex and stand up to change position it just dies. It doesn’t make sense to me and can’t find anything about it on internet... a lot suggest venous leak but radiologist confirmed I don’t have this.. but then again he done Doppler whilst I was lying down so maybe it’s not accurate? Another thing I’ve found is I no longer get random erections ever while walking around.. I used to get these all the time... it makes me convinced something physical is going on as I’m only 36 and I think that it’s still normal for me to get those at my age?

[Asdf1234]

Anyone?

[melting]

Venous leakage, I made a big post about it somewhere.. In an otherwise healthy individual with no injury to the venous system it might just be a weak pelvic floor..
The venous systems function IS to "leak". Arteries bring blood in - veins bring it out.

In the penis the hard tunica is supposed to occlude the outflowing veins to keep the blood inside to maintain erection.
Arteries create the pressure into the smooth muscles that then fill and press the tunica which then occludes veins.
Arousal and then chemicals are needed too. The pelvic floor muscles are needed ALSO! They help start the erection and help maintain it.

The Ischiocavernosous muscles for example "pinch" the outflowing(veins) top side. If your pelvic floor is out of balance then the IC's can't do that. That often gets obvious when you move position!
Many guys who grew up in era of pornhub have problems cause they wank in the same position for years. Sitting. I remember as a teen having magazine pictures and posters to wank - STANDING!

In germany socialist medicine its hard to get viagra etc. for these issues. In US you just eat some pills and it forces the erection but obviously it might just mask a problem that then gets worse that could be solved by training the pelvic floor.
I think you might profit from that-balanced, stretched, relaxed and trained pelvic floor.

[Asdf1234]

First Doppler they were unsure second Doppler concluded no venous leak

[melting]

I dont know about your specific case but it's totally possible to have a venous leak one day and the other not. A happy relaxed day, probably not.. but a stressed tense day it's again there.

[Sten1]

I dont know about your specific case but it's totally possible to have a venous leak one day and the other not. A happy relaxed day, probably not.. but a stressed tense day it's again there.

How so ? If one day there is a venous outflow and another day does not - this means that this is not a condition that is irreversible. As far as I know from the many articles I have read, this condition is constant and is not affected by anything. If one day there is and another day there is no venous outflow, in my opinion this is not the classic venous outflow. The problem is different. Blood flows from the veins after interruption of visual or physical stimulation and this is not a venous leak. This is perfectly normal - in my opinion.

[Sten1]

How come one day a person may have a venous leak and another day not?

[melting]

stan, I already explained..

In the penis the hard tunica is supposed to occlude the outflowing veins to keep the blood inside to maintain erection.
Arteries create the pressure into the smooth muscles that then fill and press the tunica which then occludes veins.
Arousal and then chemicals are needed too. The pelvic floor muscles are needed ALSO! They help start the erection and help maintain it.

Of course if you have already bad inflow, "weak arteries", "low arousal chemicals" and are unfit and unhealthy, you probably have it everyday and it's constant. The worst cases that show up and that then high % go into literature are most probably that.
Also if your veins are damaged or you have some condition it's unrelated to the erection quality or inflow. Of course..

Consider that blood circulation to the penis is on a similar path as leg blood circulation. If you have muscular fit legs then chances are high you got great blood flow to the penis too.(if nothing else obstructs)

Now.. with peyronies, when a plaque sits right at the tunica where it is supposed to "occlude" the veins.. and then you have an erection it's also possible that the tunica is not able to perfectly occlude the outflowing veins. That could show up as a "venous leakage" too.

There can be so much wrong with this whole leakage thing. I think it mostly gets tested with chemically induced erections at the doctor. If that erection isn't 100% then you again will have "venous leakage".

The only time a fully healthy penis is not "leaking" is when it has a 100% hard erection.

So the real question to ask is, "why is there a venous leakage"? It's not enough to just diagnose one.

[Hawk]

Since your desire is also reduced have you had your testosterone checked?  If it is low it can clearly cause lack of desire and weak erections.

I would take something to encourage erections since erections keep the tissue healthy.  A few things to try
L-Arginine - 1000mg 2 or 3 times a day (over the counter)
Daily Cialis (prescription)
Trazadone - 1/2 of 50 mg tablet at bedtime with a light snack (Prescription) - VERY cheap, helps with sleep, causes night-time erections but not much help with daytime erections.  Most doctors will prescribe it for sleep if you ask.

[Asdf1234]

The doc and urologist said my testosterone levels were fine. This is really messing with my head as I’m only 36 and don’t understand how I can get a decent erection lying down but when I stand it goes quick. I can get a semi standing up but nothing more. I sometimes get morning wood which is decent but goes when I stand up to go to toilet. I never feel I can get aroused standing up it’s just weird. My penis looks a bit different too like it seems stiffer and more engorged when flaccid. The colour of my penis appears to be much darker tan too? My question is can all of this be 100% psychological and be cured? I have bad anxiety and depression and thought that this might be the cause? Something to do with sympathetic tone? I did notice about 5 years ago my ejaculate volume  And force reduced significantly and has been the same ever since. Now when I ejaculate it’s seem very thick and no seminal fluid or precum? There’s not Much volume maybe about a teaspoon or just under.dopplers showed no plaques or and scarring and they said that they would be able to see any trauma from the past. But there is nothing. It just feels as if my penis is out of sync with my mind. Like the connection is blocked in some way?

Thanks for the suggestion of the meds Hawk I’ll give it a try.

[Hawk]

Our minds are powerful and can affect more than we usually think so I would say that it certainly could be psychological.  It is difficult to know.  You should be aware however that Night Time Erections (NTE's) use different pathways than waking erections caused by physical or mental stimulation.  When I had total Erectile Dysfunction from surgery I could tale Trazadone at night and get good erections for long periods but just as soon as I would rouse enough to consider using it it was gone.  If your morning wood tends to disappear when you are fully awake but still lying down it might not be the position but rather a NTE vs a stimulated waking erection.

[Asdf1234]

I think I’m still getting NTE. I do wake up in middle of night with them, then other times I’m dreaming of sex then I awake expecting to have one and I don’t. It’s so weird and it’s as if everything is completely out of sync. I can maintain them through masturbation upright kneeling and lying down it’s just when I stand up it’s as if there is no arousal and they are lost immediately. It doesn’t respond in any way whatsoever whilst standing. It’s as if my penis feels numb and unresponsive whilst stood up. I did take Cialis 5mg one night a few weeks ago. And the next morning I was walking to the front door and I got a random wrection and had to wait a couple mins till it went down before I went out. That’s the only time anything like that’s happened in I don’t know how long. So bloody weird

The thing I’m worried most about is the penile tissue health. I did say to the andrologist and she told me “nah don’t worry about that kinda thing your too young“. I felt as if she couldn’t be arsed with me. Doppler showed 51.4cm/s inflow and 2.9 cm/s outflow. The consultant said I defiantly don’t have a leak. I said to him why didn’t you do the Doppler while I was standing up because that’s when I have the problem and he told me it’s not necessary because it would have shown up either way. He told me you have no plaques or any scarring whatsoever and he would be able to see from Doppler. I asked about fibrosis or calcification and he said no nothing. He said your scan was normal. One more thing that I find very weird is after I take a Viagara it works within about 2 minutes and I have very strong erections with it. That leads me to think it’s more of a  placebo effect As I didn’t think viagra worked that quick? And I can get erections standing with it. Another thing that could suggest my problem is psychological?my morning wood stays mostly as long as I don’t think about it but will lose it once i start thinking. And always as soon as I stand up it’s gone within 10secs... I’m just totally confused because all the reading I have done says it points to a classic case of venous leak but then the docs say no. Can depression and anxiety reduce libido and sex drive significantly without lowering testosterone?

[melting]

This is really messing with my head as I’m only 36 and don’t understand how I can get a decent erection lying down but when I stand it goes quick. I can get a semi standing up but nothing more. I sometimes get morning wood which is decent but goes when I stand up to go to toilet. I never feel I can get aroused standing up it’s just weird. My penis looks a bit different too like it seems stiffer and more engorged when flaccid.

Most of this is totally normal but can be a problem when pronounced.
Clearly, it sounds, like you have a weak and/or tense and/or unbalanced pelvic floor.
Stiff engorged flaccid could be the condition called "HARD FLACCID" which is also a pelvic floor issue.

If you are stressed anyway then this plays totally into it too. Often the PF clenches in stressful situations without you noticing.
Relax, balance and strengthen your PF. (if you only do strength it could make things worse)
Lot's of ways to do that and info to find about. I wrote extensively about it just days ago I think

[Asdf1234]

Most of this is totally normal but can be a problem when pronounced.
Clearly, it sounds, like you have a weak and/or tense and/or unbalanced pelvic floor.
Stiff engorged flaccid could be the condition called "HARD FLACCID" which is also a pelvic floor issue.

If you are stressed anyway then this plays totally into it too. Often the PF clenches in stressful situations without you noticing.
Relax, balance and strengthen your PF. (if you only do strength it could make things worse)
Lot's of ways to do that and info to find about. I wrote extensively about it just days ago I think

This sounds like a load of rubbish to me. What solid scientific evidence do you have to back this up? If tht is was the case then why arent all doctors and andrologists using this to help people? Sounds a lot like the nofap crap you hear about.

[melting]

Well, research it yourself...

Understand how the pelvic floor works, the science is all out there, and do the 1+1 if that's the reason why erections are different in different positions and how a not perfectly working pelvic floor will amplify it.
Maybe start with an anatomical diagram of the pelvic floor.
To me it's obvious..?

Hard flaccid is weird but well documented by a lot of people on the web with some offering how they solved it. Not sure if you have it but sounds like it.

I'm no proponent of nofap.(also no proponent of too much fap, especially not fap in the same position all the time CAUSE.. yeah the...)

[Hope77]

 I thought i had venous leak all through last year and was filled with all sorts of fear and depression. I discovered my problem stems from a pelvic floor caused by poor posture and anxiety. I am still on my way to recovery but i never had a venous leak as i thought.

As at last year my pelvic floor was so tense that i couldn't get erection while standing with cialis. But this year after improvement of posture (i corrected anterior pelvic tilt) and pelvic floor relaxation, i can maintain erection while standing with cialis. I still have PF spasms and weak erections but i am getting better.

Many people have pelvic floor dysfunction, prostatitis ,etc and think they have a leak because symptoms are similar.

And no the true venous leak does not come and go, it is irreversible unless surgery. You likely have a dysfunctional pelvic floor that relaxes in certain occasions where you have lesser stress and anxiety.

Also check your posture!! If you have APT, your core and glutes will be weak and thus when standing all the pressure/weight of your body will be on your pelvic floor causing it to tighten and contract. Of course blood floor is very difficult in this state and you have weak erection.

[Hope77]

A very major symptom of pelvic floor tightness is hard flaccid. In this condition, your pelvic floor is in a constant state of "kegel" and is thus overtights .

Kegels are good for strengthening pelvic floor but bad for someone who already has a tightness or dysfunction. For a tight pelvic floor, you should be doing reverse kegel and pelvic floor stretches.

To me, this looks like your case!!

[RedWilly]

I went for a repeat Doppler today after the first one suggested I had venous leak on the left side. Today they done another Doppler with a stronger injection on the left side and the doc said that it was normal and no venous leak with good arterial inflow. I asked about Peyronies and he told me that there are no plaques or scar tissue and they would be able to see that from the scan so said that I don’t need to worry about Peyronies.

The trouble is I still find it hard to maintain an erection especially when standing? I get morning wood sometimes but as soon as I stand up it disappears. I also think my sex drive isn’t what it used to be. If the doc says no venous leak and no Peyronies then what else can be causing this?

Pelvic floor dysfunction maybe?

[Asdf1234]

I thought i had venous leak all through last year and was filled with all sorts of fear and depression. I discovered my problem stems from a pelvic floor caused by poor posture and anxiety. I am still on my way to recovery but i never had a venous leak as i thought.

As at last year my pelvic floor was so tense that i couldn't get erection while standing with cialis. But this year after improvement of posture (i corrected anterior pelvic tilt) and pelvic floor relaxation, i can maintain erection while standing with cialis. I still have PF spasms and weak erections but i am getting better.

Many people have pelvic floor dysfunction, prostatitis ,etc and think they have a leak because symptoms are similar.

And no the true venous leak does not come and go, it is irreversible unless surgery. You likely have a dysfunctional pelvic floor that relaxes in certain occasions where you have lesser stress and anxiety.

Also check your posture!! If you have APT, your core and glutes will be weak and thus when standing all the pressure/weight of your body will be on your pelvic floor causing it to tighten and contract. Of course blood floor is very difficult in this state and you have weak erection.

Thanks for your reply, I couldn’t help but notice though. Your sig describes different problems to pelvic floor dysfunction...why is that?

[TonySa]

Asdf, in a recent post you said you had better erections in 5mg cialis?  If you take it nightly it may benefit you everyday.

[Asdf1234]

The cialis doesn’t work hardly. I went for a penis MRI today but they done it without inducing erection. This doesn’t make sense to me? How are they supposed to see what’s going on without doing that?

[TonySa]

What dose and how often do you take it

[Asdf1234]

I started on 5mg and wasn’t working so upped to 10mg then that stoppped working so I’m not taking anything now

[Asdf1234]

Just want to get to the bottom of this and find out what’s going on. All the docs keep telling me am too young to have Erectile Dysfunction and no signs of plaques etc.
No heart disease so it’s more than likely purely psychological but I don’t think so... I mean I don’t get any random or spontaneous erections at all...NOTHING! Surely if it was psychological then it would be intermittent...also the ejaculate volume being very low.. also ZERO sex drive or libido...this to me all points to a physical problem...and they have told me no details and I have been going to urologists for 2 years now..it’s torture

[jan.schaller1958]

Have they checked your testosterone levels? No diabetes, no high blood pressure?

[Asdf1234]

Yes they done a full blood count. Checked thyroid, hormones and testosterone. My levels normal testosterone over 550. No diabetes or anything. Blood pressure docs said was normal. I do my own blood pressure from time to time and it’s 120/70 I do have an abnormal heart rythym, ectopic beats. But cardio said it was nothing to worry about and causes no complications other than a bit of discomfort from time to time. Had 2 DopplerS one showed venous leak One showed normal. Now the mri.. if this shows up normal then I really don’t know what else to do..it’s as if I’m constantly trying to get to bottom of this and forcing them to come up with an answer but still nothing. At first the docs said I had health anxiety but there is no way this is that.. there’s something not right I know it

[TonySa]

It sounds like you’ve found a solution to your Erectile Dysfunction which can be used regardless of the cause.  I’d say go out, use it and try to enjoy it-it may reduce your anxiety w even added improvements in EQ!

“ One more thing that I find very weird is after I take a Viagara it works within about 2 minutes and I have very strong erections with it. That leads me to think it’s more of a  placebo effect As I didn’t think viagra worked that quick? And I can get erections standing with it. “

[peter123]

i had pelvic floor dysfunction for almost a year when i was 20 due to overmasturbation(4times a day) and it went away aftr a while and 3 months of tadalafil

[Asdf1234]

But it says in your signature you have Peyronies and Erectile Dysfunction? How is this pelvic floor dysfunction?

[peter123]

had. as in 2017

[Asdf1234]

So went to doc today and he said my MRI was unremarkable, no signs of anything whatsoever and he tells me that my Erectile Dysfunction is psychological. Now he’s giving me a follow up appointment 3 months away. I’m still no satisfied and know there’s something else going on. What should I do?

[TonySa]

Sounds like you should be relieved.  Try not to worry, relieve stress and when needed use Viagra.  You’re in great shape-will you be able to accept that, not everyone would but I hope you do.

[bendywilliams]

I have the opposite problem.  My erections are decent when standing, zero when laying down, and half full when sitting. The only sex I can have is doggy or missionary.  Also I developed a bend over the years even though I feel no plaque.  One side of the one is is longer and the shorter side is the direction of the bend. Hope you find a solution,, but it sounds blood pressure related. Check your bp when standing vs sittting.

[Asdf1234]

Would they be able to tell from Doppler and mri any history of trauma to penis and testicles however long ago it was and however small the trauma was?

[Asdf1234]

Anyone?

[FlavioSousa]

Thanks for your reply. I’ve been on Cialis 5mg for the last couple of months. They help a bit but still problems when standing. It leads me to think the problem I have must be psychological. They told me yesterday that my pulse was all over the place and I have ectopic beats. I do suffer from severe anxiety and depression

If this really is psychological, apomorphine may be helpful. I suggest you read my thread on this:

https://www.peyroniesforum.net/index.php/topic,14420.0.html

The mind can have a drastic impact on your sex life and yes, anxiety and depression are major causes of Erectile Dysfunction. The good news: it is easily treatable.

I am also extremely anxious and I have a trick that works really well: whenever I have a negative sexual experience, I quit sex for a while, just to forget about it and clear my mind. Information is tip #2: the more you know about sex, the less stressful it will be.

[Asdf1234]

Yes but can the mind stop you having erections 24:7? As in no random erections throughout the day over months and months?  I was with a lady the other night and it appeared I had no problems at all. Then I remembered I took 5mg CIalis 3 days previously. Would this still have been in my system?

[Asdf1234]

Libido appears to be non existent aswell. Can the mind shut this down 24/7?

[Asdf1234]

Anyone?

[TonySa]

20 mg cialis lasts about 36 hours.

[Asdf1234]

It was definately 3 days since I took the pills. Was just thinking because they say they only work optimally for 36 hours perhaps the half life is much longer and maybe some of the drug was still in my system?

Lately I’ve found that when masturbating I sometimes can get fully erect and others hardly at all and end up ejaculating soft. It’s really messing with my mind in a big way. I just don’t get it? I have found that my anxiety levels are high when I go to masturbate and my mind is focused on it.

Then the other thing that I read is that if you can get hard to masturabate then it’s a psychological issue well my problem is half and half. There’s got to be something underlying here.

90 degree Peyronies + Erectile Dysfunction + Conflicting Doppler Results

Started by Allyn Surgery for Peyronie's Disease

Ultrasound and Doppler

Started by Kickit40 Ultrasound and Extracorporeal Shockwave Therapy (ESWT)