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Went to a doctor who specializes in penile implants. He right away said that you are too young and you cannot get an inflatable implant. He disregarded my two Doppler tests which detect a venous leak. Maybe he is right about that I'm not the expert here.

He said my condition is psychological. I disagree with that, there maybe something wrong with my brain but I am a high functioning adult with a good job etc. There might be something wrong with the arousal part of the brain but otherwise I'm ok.

Obviously I did not expect he will implant me in the first meeting. But I need him to be open to do it.

He gave me the same old medicines Cialis, L Argenine, and biupropen. I take Cialis regularily and a bit of Argenine. Biupropen is new and I want to try that. Obviously I am not thinking I will be miraculously cured by this. I will meet him again in 2 weeks. I don't know what the next steps are.

For the mental part the only thing that keeps me going is the possibility of an implant. I check these forums everyday to read about implants and assure myself. I am scared if I don't get cured I will just break down. It happened to me one year back. I just gave up on everything and couldn't even move myself from the bed for few months.

Thanks to my busy current job my mind is occupied by my job and I have saved enough for an implant.

I just want to be able to look a woman in the eye and be happy. I have so many nice friends but I don't go out and am anti social. I look as if I live a normal life but I'm deeply sad inside.

I can't take it anymore.

I'm not a doctor so I can't give you medical advise. But as a sufferer of ED for many years I strongly suggest not just taking his word for it but seek other opinions. If other doctors are in agreement, then I'd listen to them. But with 2 Dopplers showing a venous leak, it would seem you do have a physical problem.
I had a similar situation years ago. I had strong desire for sex so that was not an issue. I kept having erection problems and finally went to a Urologist. He basically told me the same, you are too young to have issues, it has to be psychological. So I beat myself up for another year or two thinking I was somehow defective mentally for me not to be able to achieve and/or maintain an erection. I then decided to try another Urologist who actually listened and did various tests including a Doppler. He found I had a venous leak and worked with me to find a proper treatment. In my case a combination of sidendafil and aprostatil injections did the trick. But had it not, he was open for an implant as well, and I was in my early 30's at the time.
So do seek other doctors and find one that is understanding to your issues and you find comfortable.

young_and_impotent wrote:Went to a doctor who specializes in penile implants. He right away said that you are too young and you cannot get an inflatable implant. He disregarded my two Doppler tests which detect a venous leak. Maybe he is right about that I'm not the expert here.

He said my condition is psychological. I disagree with that, there maybe something wrong with my brain but I am a high functioning adult with a good job etc. There might be something wrong with the arousal part of the brain but otherwise I'm ok.

Obviously I did not expect he will implant me in the first meeting. But I need him to be open to do it.

He gave me the same old medicines Cialis, L Argenine, and biupropen. I take Cialis regularily and a bit of Argenine. Biupropen is new and I want to try that. Obviously I am not thinking I will be miraculously cured by this. I will meet him again in 2 weeks. I don't know what the next steps are.

For the mental part the only thing that keeps me going is the possibility of an implant. I check these forums everyday to read about implants and assure myself. I am scared if I don't get cured I will just break down. It happened to me one year back. I just gave up on everything and couldn't even move myself from the bed for few months.

Thanks to my busy current job my mind is occupied by my job and I have saved enough for an implant.

I just want to be able to look a woman in the eye and be happy. I have so many nice friends but I don't go out and am anti social. I look as if I live a normal life but I'm deeply sad inside.

I can't take it anymore.

Do you take any medications? Some can have side effects (and some have E.D. as a side effect, sometimes rare). I don't know if any can induce venous leak, but a medication that relaxes the muscles that are SUPPOSED to restrict venous outflow from your penis could well do that. Pharmacists often know more about side effects and INTERACTIONS than doctors who prescribe the medicines.

Implant is a radical step and your doctor is right to discourage it until all other avenues have been exhausted or rejected. Youth is not a barrier to implantation, but implant in a young man when better treatments (or even a cure) may be in the pipeline for FDA approval is medically unwise. Consider talking to him again and asking for his reasoning. If he will not share that with you, find a sexual health urologist/surgeon who will.

Good luck. Keep your eye on the prize (the prize is not an implant, by the way, but a satisfying relationship - which likely will include sex, but there are many different kinds of sex that do not necessarily require coitus but are satisfying nonetheless)

To be clear I have really severe ED. Don't remember when I had a sustained erection. When I take tadalafil everyday and work out I get some hardness in the morning.

I think my problem is that I am not assertive. I'm basically scared that the doctor will shut me up and think I'm a dork/lying. He said I didn't have a venous leak because it said on my papers that that my 'end-diastolic' blood flow was 3 cm/s which is less than 5 hence no VL.

The exact lines are

The delayed study shows persistence of end-diastolic blood flow on both sides of more than 3 cm/sec suggesting venogenic cause of arterial incompetence.

I agree very poor choice of words using 'more than 3'

The other report clearly showed EDV at 20 mins after injection to be 5.5 cm/s and 5.7 cm/s on right and left side. I guess he didn't read this part as this was hand written.

In both tests I did not get a full erection. One of the reports even mentioned that.

Can somebody really rule out VL after these results. I will discuss this with the doctor in my next appointment in 2 weeks.
Till then I will take the SSRI and Buspirone he has given.

young_and_impotent wrote:To be clear I have really severe ED. Don't remember when I had a sustained erection. When I take tadalafil everyday and work out I get some hardness in the morning.

I think my problem is that I am not assertive. I'm basically scared that the doctor will shut me up and think I'm a dork/lying. He said I didn't have a venous leak because it said on my papers that that my 'end-diastolic' blood flow was 3 cm/s which is less than 5 hence no VL.

The exact lines are

The delayed study shows persistence of end-diastolic blood flow on both sides of more than 3 cm/sec suggesting venogenic cause of arterial incompetence.

I agree very poor choice of words using 'more than 3'

The other report clearly showed EDV at 20 mins after injection to be 5.5 cm/s and 5.7 cm/s on right and left side. I guess he didn't read this part as this was hand written.

In both tests I did not get a full erection. One of the reports even mentioned that.

Can somebody really rule out VL after these results. I will discuss this with the doctor in my next appointment in 2 weeks.
Till then I will take the SSRI and Buspirone he has given.

I interviewed three surgeons before selecting one to do my surgery. It took 14 months to find the one I eventually chose. I do not regret the time spent, as I made an optimal choice and had a VERY good outcome for the effort.

None did a VL study. All three listened to my description and made a diagnosis 100% based on a single clinical examination that I was a an appropriate candidate for an implant.

My situation differs from yours in that I am 70 years of age and have a history of diabetes. This may have contributed to their willingness to recommend an implant. I was also well-read and well-versed (for a layman) in the literature in the medical journals and had a degree of self-confidence and acceptance of my condition. You seem to have those attributes, despite your suspicion that you may not be asserting your clinical impressions clearly enough.

Write down the narrative you would deliver to a surgeon describing your (observed) history of (lack of)) nocturnal and morning erections, what it takes to get an erection with or without medication and any experiences you have had with coitus (successes as well as failures). Commit the lab reports of your dopplers to memory so you can cite chapter and verse and include these in your written narrative. Practice delivering it as if you were speaking to your surgeon. You don't want to be tongue-tied during an office visit.

Get a vacuum erection device and start daily stretching of your penis. You want to maintain elasticity of those tissues and flush oxygenated blood through them twice daily. Do not over-pump. Take measurements (length and girth) and photographs. They will help in the immediate future as well as decades from now.

Focus on a goal is a marvelous preventative against depression. Stay focused, no matter how long it takes. And remember. (I suggest) The goal is not an implant. The goal is the ability to have sex. An implant may be the best way to do that, but maybe not right now. There may be better solutions to use in the meantime. Be open to all satisfactory solutions and/or stepping stones to get there.

Fire your uro! See others!