can Erectile Dysfunction always be diagnosed?

[Kickler]

i have symptoms of Erectile Dysfunction, i can get a normal erection but it is never long lasting snd rewuires physical stimulation but even more so, mental "attention" meaning that as soon as i do not focus on something arousing, i lose the erection. i want to find the reason for this problem, is there a test that can with verx high certainty tell what exactly is going on, whether it is psychogentic, organic? as i understand it it could be a multitude of things such as hormonal, psychogenic, just purely genetic reasons(weak erections?). while i do not have full blown Erectile Dysfunction i miss actually being able to masturbate for satisfication and that requires a solid erection.

i cannot have sex due to peyronies but having a high sex drive coupled with ED is like pure hell. i dont know wgat to say, its total madness to me and i never get diagnosed properly, just an ultra aound and thats it.  

[Asdf1234]

I was told that there could be small microscopic changes in the vascular system that can't be detected and only detected a few years down the line from the onset of ed.

[Kickler]

what i am trying to find out is how much of my ED is psychogenic and how much is organic. itis sooo frustrating to go to the urologist and they don't even give a crap about the cause of your ED, they just gave you pills. asa young man the idea of being depemdent on viagra your entire life is destructive. it totally ruins it for me. so there has to be some set of tests to rule out all the other crap like hormones, scar tissue, vascular issues to the point where it's narrowed down to a certain set of causes? i want this type of diagnosis not  " oh that can happen, just take these pills for the next 50 years".

i also want to understand the potential diagmostic difference bewteen not being able to GET and erection vs not being able to HOLD an erection. there must be a difference right? because whem you can GET an erection, arterial malfunction can basically be ruled out etc.

[Asdf1234]

Doppler shows arterial inflow and venous outflow. Inflow has to be above 35 m/s and outflow has to be less than 5m/s. The inflow is your ability to gain an erection and outflow is ability to hold an erection. If the outflow is more that 5m/s then you are classed as having venous leak and not able to maintain an erection. Hormones I think they just go by testosterone being a certain level and if it's above that then it's not the cause. All the tests I've had are clear and yet I can't hold an erection whilst standing and they have told me my Ed is completely psychological. They reckon there has been a one off time I couldn't get erect while standing and it has created a vicious feedback loop in my mind. It's weird since my symptoms appear to be venous leak but they say it's not. My psych said that psychological Ed can mimic physical Ed and you can't tell the difference between the 2. The good thing is that psychological Ed is reversible which my psych is confident of doing so have to take her word for it.

[shrunken_dick]

I have severe erectile dysfunction that can't be diagnosed using colour doppler test. My case is not psychogenic because I have lost 1" inch erect length. My flaccid looks incredibly smaller. It's a shame that when it comes to male sexual health, urologist have no clue about what's is happening to patient's penis.  

[Asdf1234]

Did they find plaques or fibrosis or anything? Surely if they haven't found anything they have referred you to psychologist?

[shrunken_dick]

They didn't find any fibrosis. I would go for caversonography. No, they didn't send me a psychiatrist.  

[Kickler]

in my case ultra sound was negative but he said that he suspects septal fibrosis

[Tortão Pra Direita]

Find a urologist that has the doppler in his clinic. The best way to find something wrong with your penis is by scanning your penis while you have an erection.
A few urologists here in my country do that. They induce an erection by injection and exam the blood flow capacity, curvature, and buckling.  

[Kickler]

but cant the injection cause damage though?  

[LWillisjr]

It is a very small risk to be considered. But is done by medical expert.