Dr. Ralf Herwig claims that he cures Venous Leak

[ED2013]

SO HAS ANYONE HERE EVER HAD SUCESSFUL VENOUS LEAK SURGERY??

I know of one Franktalk member that had it and it helped him somewhat. It's not permanent though. Over time, you're back where you started.

[fandijoe]

yeah that's what I thought.. I heard it don't work in most cases.. so def not worth the surgery and potential future problems

[Echegollen]

Hi Echegollen and the other guys on this thread,

Firstly sorry for my absenteeism over the last few weeks, I was waiting for my appointment so thought I would hold off until I had something tangible to report back. So then I’ve had my first consultation with Dr Franklin Kuehhas at the International Andrology Institute in London last week and can say it was an interesting day out to say the least! Firstly we discussed my history with ED and he asked many questions in terms of my ligation surgery in 1997 whilst he got a better understanding of the drugs I use and their success rates.
After the initial chat had finished I was asked to undertake an ultrasound which involved a caverject injection to force an erection! Well it sort of worked but I was extremely nervous I did lose it a few times so he came back into the room on 4 occasions in order to complete the scan. After we had finished he told me that my inflow results were good, however and as expected the outflow was not great hence venous leak present (again no surprise).

We left this room and went back to his office where he drew a graphic of a penis, pretty standard stuff at first in terms of blood flow in, however and everyday being a school day and all that I learned that the veins that allow blood to drain out from the penis actually go into the prostate and this is the case for over 90% of the male population with less than 10% elsewhere into the abdomen which as I will explain is unlucky for the ones who have a venous leak because it’s impossible to track the vein and hence close it down, however this potential quirk of fate doesn't show up on a scan so will only present to the surgeon when you are opened up on the table and this appears to be the only risk with regards to an improved situation post opp.

So to summarise I was deemed a good candidate for Sclerothreapy and because I no longer have a deep dorsal vein after the '97 opp the leak has clearly presented elsewhere, so the next steps, success rates, risks and cost as follows:

Next steps: Operation performed only in Vienna where Dr Kuehhas works half the week. 2 day stay with cavonosagram performed on day 1, this takes about 30 mins and involves an induced erection with a tracer fluid pumped into to target the source of the venous leak. Day two is the operation which about 20-30 mins under a local anaesthetic. A 1.5 – 2cm cut is made with fluid injected into the offending vein to collapse the structure to close it off. The operation is minimally invasive and you can fly back the next day. You will then be given daily Cialis for 1 month which I suspect is to get the blood pumping around. No intercourse for 3 to 4 weeks.

Success rates: A total success is a sustainable erection good enough to penetrate and perform / complete intercourse without the aid of PD5 drugs. This is about 65%. Partial success is the above but lower dose PD5’s still required, this is about 15% so I’m assuming that 20% see no betterment post pop but I was assured by the doctor no one receive a worse outcome after surgery.

Cost & availability: £4,000 (UK) which includes flights and hotel in Vienna for one. This is organised by the clinic. Being a private medical service you could have this performed with 2-3 weeks if you have the money and free time.

Risks: You are the unlucky 10% whose veins don’t travel to the prostate so its cost you £4k and you are still back at square 1!
I hope this helps and picking on Echegollen question regarding to why other surgeons don’t offer this treatment? Well I can’t speak for other countries but here in the UK the NHS really puts little focus into research so they rely on trusted methods such as PD5’s, injections etc… and they remain reluctant to test so we all end up being just put into a generalised ED bracket rather looking at our individual needs.

As for me I believe this could be a good option, however because of the high cost of surgery and the fact Viagra still hits the spot 75% of the time I’m going to take the summer to consider things so won’t rush in yet, however if my erections start to wain I could go for this before year end.

That’s enough for now but if you have any questions please ask whilst I would be happy to talk to any of you on the phone if you wanted to? Just let me know and I would message my number.
In the meantime take care and remain strong.

Gollam.

Thank you very much Gollam for sharing your experience with the rest of us. It is really generous of you.

The total success rate (95%) is incredible compared to the success rate of the ligation surgery. In fact, I haven’t heard yet of a single success story of ligation surgery. Having this said, who knows where they picked up those success rates. Again, if this surgery was so effective, how come it is only performed by them? This makes no sense.

You are lucky viagra still hits the spot 75% of the time. In my case, pills aren’t effective. The only thing that is working for me right now is caverject. However, not only injections are very impracticale, but I am only 31 years old and I am worried of the side effects of such a long usage of injections.

From what I understand, since you no longer have a deep dorsal vein because of your ligation surgery in 1997, you need a cavonosagram. I assume the cost of the surgery would probably be cheaper for someone who didn’t have a ligation surgery and still have a deep dorsal vein.

What I am wondering though is if you still have leak after having removed your deep dorsal vein, I don’t see why another leak wouldn’t be created after a sclerothearpy treatment…

If you do decide to get the operation, I pray God that you will be again very generous by sharing your experience.

Good luck.

[Echegollen]

I got Implanted at 35 years of age after struggling with venous leak all my life. I was offered crural ligation surgery by a well known specialist. He seemed very enthusiastic to do the surgery. When pressed for answers in writing by email, he admitted that the surgery may not work and is not permanent. You could be back to square one very quickly. I believe that the psychological effects of Ed had already taken its toll on me, and would still give me problems. I opted for an implant, and couldn't be happier. The ability to have a rock hard erection on demand and for as long as I (or she) wants has been extremely liberating and satisfying to me. I went through it all, saw multiple uros who said it was all in my head. I used pills and injections too which didn't work well either. Bottom line is venous leak is rare in young, healthy individuals. Surgery to fix it is also no matter what they tell you indeed experimental. I urge you to proceed with caution. I spent many sleepless nights searching online for answers. Best of luck to you

I am happy that you had good results with your implants. That is definitely an option I am considering.

May I ask you how long ago you had your implants?

[ED2013]

October 2013

[Seeking]

This is my first post on this forum - let's hope it's a useful one.

I'm 28, had ED for four years, symptoms mirror those of venous leak exactly (and low and behold, this was diagnosed a week ago).

I've been for a consultation + ultrasound doppler at London Andrology and am in the final stages of booking this procedure at their Austrian clinic. My doppler showed that although arterial inflow was very good, my venous outflow was significant and this is evidently the organic cause of my ED.

Some people have quite rightly asked why this isn't available on the NHS or used by any other large public health body and there's a simple answer to that: economics. A treatment will ONLY be implemented on a grand scale if its efficacy is reliably and consistently demonstrated over a significant period AND it is cost-effective. These two factors are inseparable. This doesn't mean treatments outside the scope of public health aren't worth trying - it simply means that by trying these treatments and stepping out to the frontier of medicine you are exposing yourself to more downside risk (usually monetary) but also possibly a better treatment outcome (you hope). In the British press there are stories on a monthly basis re: new drug treatments that haven't been taken up by the NHS due to cost, but that are demonstrably more effective than the treatments currently available; thus, it isn't always a matter of lack of efficacy. That being said, why MORE research hasn't been done into sclerotherapy is strange, but far FAR stranger things have happened.

The use of Sclerotherapy in a non-research setting to treat ED is both novel and extremely expensive (for what is basically a glorified injection + X-ray) and I'm informed its efficacy depends entirely on which veins in your penis are the leaky ones - it's therefore too much of a gamble to be used in public health. If the veins closed off by the procedure (which I'm also told aren't case dependent - its the same ones each time) are the ones causing your venous leak, then prepare to be thrilled by the results. If those veins they close off weren't even pathological in the first place, you've just set fire to £3500 and your journey through the ninth circle of hell continues (but at least no further damage has been done).

I'm more than happy to fork out for this procedure as I'm close to the end game with my ED now. Before getting an implant and getting my entire member hollowed out, I want to be sure EVERYTHING possible has been ticked off the list. If this sclerotherapy procedure doesn't work, I'll become a pill popper until their efficacy tails off, then it's probably onto the operating table unless something completely unforeseen in the world of ED research trials comes up.

I'll obviously be keeping all of you in the loop on this and let you know how my experience goes. I'm not hopeful at all that it will work, but that's purely a psychological protection mechanism - a GP that I respect hugely and that is extremely knowledgeable told me that, if I'm sure money isn't an issue, this is absolutely worth trying.

Feel free to fire any questions my way.

Peace.

[wolfpacker]

Hey man, I just replied to your post but I had some thoughts after reading this post as well. First I am super super interested in your sclerotherapy experience. Please post every detail of the process, as no one here has ever posted that as far as I can tell. Second, you mentioned going from a pill popper to the implant. Although it may sound scary, I would definitely consider injections after pills but before implant. There is a huge benefit to the injections that most people dont know about: they will increase your penis size over time. PGE1 is used in penis enlargement and is extremely effective. Just FYI!

[Echegollen]

Thank you very much Seeking for your post! Since I have discovered this site, I check to see if there is any new posts at least once a week. It had been a while since someone had posted something. You really made my day! Like Wolfpacker said, no one has ever posted their experience with sclerotherapy yet. Obviously, there is always a risk that you are working for London Andrology and you are just trying to convince us to spend £3500 but you seem to be legit... I pray God you are!

I am a little bit confused though... If you really have a venous leak, I don't understand how you started to suffer from ED only 4 years ago. Unless you had some kind of trauma in that region, I thought a venous leak was congenital (born with it). I am 31 years old and I was never able to maintain an erection. Trust me, I don't wish that to my worst enemy!

Can't wait to hear from you again and I will pray God that your surgery be successful.

[Echegollen]

Hey man, I just replied to your post but I had some thoughts after reading this post as well. First I am super super interested in your sclerotherapy experience. Please post every detail of the process, as no one here has ever posted that as far as I can tell. Second, you mentioned going from a pill popper to the implant. Although it may sound scary, I would definitely consider injections after pills but before implant. There is a huge benefit to the injections that most people dont know about: they will increase your penis size over time. PGE1 is used in penis enlargement and is extremely effective. Just FYI!

That is very interesting... I've been using injections (caverject) for a few months now. I have never heard of this. I'll definitely do some research. Are you using injections yourself?

[wolfpacker]

I'm not using them yet because the pills still somewhat work for me. Search "pge1 enlargement". As soon as the pills quit working, I cannot wait to get on caverject/pge1 and gain size.