Dr. Ralf Herwig claims that he cures Venous Leak

[Seeking]

Hi Domino, thanks for checking in - it's certainly good to get a fresh view on this topic.

Any kind of venous treatment for erectile dysfunction carries the enormous caveat that one day the situation will revert back due to neovascularisation, and I'm under no illusions that sclerotherapy might also carry that burden which is why I'm managing my expectations very carefully on this one and taking this one day at a time.

However, on the flip side let's consider everything in the round:

i.) Aethoxysclerol has never been used as a sclerosing agent before until Herwig used it in his 2015 paper; therefore, this sclerotherapy technique is completely novel.
ii.) The success rate after 12 month follow up for this surgery was reported at around 72% which had dropped from 80% @ 3 months due to, what Herwig hypothesised to be, neovascularisation i.e. vein regrowth. This is a small percentage compared to the relapse experienced by ligation patients but at least Herwig has acknowledged that some people did revert back.
iii.) Venous ligation surgery is extremely savage, requiring a long recovery period, whilst this surgery is minimally invasive and done on an outpatient basis with a 2 week recovery period before intercourse can happen.

Yesterday, 2 days after my op, I got a huge hard-on from looking at a picture of a girl in a nice dress. Not naked. Not getting pounded on some sofa by some douchebag. Just a girl who looked pretty and was fully clothed. Therefore - whilst I am absolutely not sticking up for the longevity of this treatment - it has directly treated the cause of the problem. This may not happen for everyone. For me this situation may not remain for very long. But for me it was worth spending £3500 for two reasons: i.) It proves venous leak exists (some urologists think it doesn't...!!!) and ii.) my dysfunction was due to a venous leak. I now know the root cause of my problem, regardless if the treatment has longevity or not.

If these effects lasted for a year (or even 6 months) and then I reverted back to having ED due to neovascularization or vein re-growth, do you know what I'd do?

I'd take a flight straight back to Vienna and get the whole damn thing done again.

Because last night I slept soundly for the first time in 4 years knowing that - at least temporarily - I was no longer living inside Hell. It's not uncommon for someone to spend £3500 sitting on some boring beach somewhere in the Caribbean for their 2 week vacation...I'd much rather spend it on something that makes me feel like life is worth living again.

My take-home message for the sclerotherapy would be this (and excuse my candid-ness):

- Sclerotherapy is not cheap, and it might not work for you
- In the ultra short-term, it's definitely worked for me, but it might not long-term and I'm making no presumption that I'll be like this in a year's time.
- In any case, it is definitely more effective than ligation surgery, regardless of whether it is 'perfect' or not, ligation surgery should be scrapped completely and this procedure made more efficient and cost effective and adopted by public health organisations; and
- Alot of urologists are doing their best, but others are definitely ignorant douchebags when it comes to ED (remember - it's a wide field and some guys are just not interested in the ED side) - do your own research, make your own decisions and draw your own conclusions.

I'll report back next week with an update on how I'm doing.

Cheers,
Seeking

P.S. My venous leak came on completely suddenly 4 years ago (Oct 2011) without any kind of injury or PE exercises. I had started a heavy squat routine 2 months before it happened and I have a lanky/delicate build so I'm not sure if that just fucked up my pelvic vasculature or what. But yeah, very sudden and no obvious cause.

[Domino]

So, of course your Erection is quite firm at the moment, cause the blood has no other options to be stopped by that closure. Well, the problem is not solved....but i think thats clear.
Embolisation and Sclero aren Lifestyle-therapies, which means they cant be repeated over and over...i think its more important to have a durable solution. How can you enjoy your life, knowing that the clock is running against you? And you have to plan another trip, spend 4000 $ and have all that stress. For me, thats not an option, i think the psychical problems which comes with ED should not be underrated.
Well thats just my opinion, for me the penile prothesis seems like a pretty satisfiying solution for candidates with venous leak.

Greetings

[Domino]

Mh thats odd, many people suggest squats to enhance the bloodflow and thereby get an better erection.
Did you do Cavernosography? Well theres one thing I dont get...Arterial Bloodflow is simulated, that means the Cavernous Bodies have no other option to enlarge an pinch the veins.
In my theory the venous leak....dysfunction starts there. I mean its interesting to know about people who have the same issue but not being born with it...
Did you ever perform pelvic floor training? Maybe you damaged you pelvic floor during Squats? I mean what could be a realistic reason for your venous leak that occured just out of nothing, thats just wierd...I really cant get behind that...

By the way, I just found this: https://www.youtube.com/watch?v=O0Y-sWMIflM
Seems to be pretty interesting, and is actually pretty plausible, cause I dont believe in a Venous Leak caused by "leaking Veins" or "too large Veins" etc.
I believe, Venous Leakage is caused somewhere between the Stadium of blood inflow and expanding of the Smooth Muscle pinching off the veins.
Because: in a healthy men, blood outflow is stopped after the cavernous bodies fill up with blood and expand, basically a pretty simple procedure.
Well maybe some of you have an opinion about that theme....

Ligation, Embolisation and other Venous Operations have never worked for longterm, and i think they never will, because its just digging at the false spot...

Greetings

[Echegollen]

But for me it was worth spending £3500 for two reasons: i.) It proves venous leak exists (some urologists think it doesn't...!!!) and ii.) my dysfunction was due to a venous leak. I now know the root cause of my problem, regardless if the treatment has longevity or not.

Was the £3500 only for the operation or you also included the motel and transportating fees?

[C_lab34]

Mh thats odd, many people suggest squats to enhance the bloodflow and thereby get an better erection.
Did you do Cavernosography? Well theres one thing I dont get...Arterial Bloodflow is simulated, that means the Cavernous Bodies have no other option to enlarge an pinch the veins.
In my theory the venous leak....dysfunction starts there. I mean its interesting to know about people who have the same issue but not being born with it...
Did you ever perform pelvic floor training? Maybe you damaged you pelvic floor during Squats? I mean what could be a realistic reason for your venous leak that occured just out of nothing, thats just wierd...I really cant get behind that...

By the way, I just found this: https://www.youtube.com/watch?v=O0Y-sWMIflM
Seems to be pretty interesting, and is actually pretty plausible, cause I dont believe in a Venous Leak caused by "leaking Veins" or "too large Veins" etc.
I believe, Venous Leakage is caused somewhere between the Stadium of blood inflow and expanding of the Smooth Muscle pinching off the veins.
Because: in a healthy men, blood outflow is stopped after the cavernous bodies fill up with blood and expand, basically a pretty simple procedure.
Well maybe some of you have an opinion about that theme....

Ligation, Embolisation and other Venous Operations have never worked for longterm, and i think they never will, because its just digging at the false spot...

Greetings

I am mostly in agreement with you here, but I also don't want to discourage anyone else or make anyone feel as though what they are doing is futile. From what I've seen and heard, directly treating the veins does not correct the underlying dysfunction with the smooth muscle tissue. It's the erectile bodies themselves that do not expand properly and pinch off the veins. The idea of closing off leaking veins has been around since probably the late 70's, and the ligation surgeries just did not have good enough durable results. The whole procedure is no longer considered an option by most practicing urologists. It seems that no matter how many veins you close off, remove, or collapse, new veins will grow and because the disorder is on the cellular level of the messages sent to the erectile tissue, no long term success can be possible.

Now, I have had three rounds of the priapus shot as well. I'm not sure if they've done me much good. Well, I had a sexual injury about a year and a half ago that made my ED worse, and also caused me to lose some size. The priapus shot has maybe restored my size, but I've also been doing exercises for that, so not sure where the bulk of the gain is coming from. It hasn't done much to cure or improve my venous leak, which remains what it is, inexorably.

[razor1]

I'm not really going to get into the discussion of if it will work, if it will last, is it a waste of money etc. I'm just going to report my experience for those that are interested. So below is my update, just under 2 weeks post op:

My surgical tape was coming off a few days ago, so i removed it fully, there is small 1cm cut and it has a loop of thread at the top. Dr Keuhhas had said to me i could cut the thread in 10-14 days if it was still there. So I'm planning to wait a few days before deciding. The cut is still a little tender and slightly red tonight (I was on a plane all day in tight pants and kept getting erections while dozing off. I think it put some stress on the cut). I don't think it's healed enough for intercourse yet, maybe another week,

My erections have greatly improved though, I had soft glans for so many years, and now it kind of hurts they are getting so hard. I did some manual testing earlier and was able to get a rock hard erection, and maintain it, all while standing. I stopped occasionally and did a few things, and it stayed hard till I finished (rather than going soft as soon as any physical stimulation stopped). So to me that's a great improvement.

Of course time will tell, but right now I am happy with the improvement so far and it seems to be getting better each day. I am glad I went for the operation.

[Domino]

Hi Clab,
well i think priapus shots can be helpful to restore the extensibility of the cavernosum (cavern bodies).
Therefore again pinch the veins leading the blood out.
Venous Leakage is not really there, its more a consequence of other malfunctions that happen in the cavernosum or if you have bad arterial inflow.
Therefore i´d like to try Priapus, because i think in most cases of Venous Leakage, fibrose or scar tissue play a huge factor.
Well what you think about it? Does Priapus adress that problem or are there other treatments to attack those hardend fibrose?

Greets

[C_lab34]

Domino,

I can't say whether or not Priapus will help you. If money isn't a problem, then I would try it out; at the very least it won't do any damage. I do think, as you do, that venous leak is just a vague term and that it usually isn't the veins that are faulty, it's the carvernosal bodies or erectile tissue. The platelet rich plasma might possibly stimulate a healing and repairing process in the tissue, and I have seen some minor benefits from 3 rounds of the shots. I am a little thicker and harder and maybe a bit more sensitive. But I still have the same underlying condition. I don't want to derail this thread too much so send me a pm if you want to talk more about the shot.

[Seeking]

I was 2 weeks post op yesterday. Everything still much improved down there but recovery is slower than was expected but at least this agrees with Razor's experience also and things are certainly still a bit tender down there. For such a small incision I'm impressed by how long the recovery has taken, I guess the sclerosant really goes to town, hence the reason your penis looks like a blood sausage for days afterwards.

Will report back in 2 weeks time when I'm hopefully adequately healed enough to see how things fare during intercourse, which is the acid test.

[gollam121]

I was 2 weeks post op yesterday. Everything still much improved down there but recovery is slower than was expected but at least this agrees with Razor's experience also and things are certainly still a bit tender down there. For such a small incision I'm impressed by how long the recovery has taken, I guess the sclerosant really goes to town, hence the reason your penis looks like a blood sausage for days afterwards.

Will report back in 2 weeks time when I'm hopefully adequately healed enough to see how things fare during intercourse, which is the acid test.

Thanks for the update Seeking, I've booked mine today for the 16th September. Told I need to have ct Cavonosagram the day before to check where the leak is actually coming from after the deep dorsal vein was removed during my ligation surgery back in 1997. Hopefully this won't be an issue and I can have the surgery the next day so fingers crossed. If the scan shows I'm not a good candidate they will only charge for the flight, hotel and scan so at least my bank account will breath a sigh of relief.

Venous leak aside I don't know what else it could be, my inflow is strong and my testosterone levels are normal whilst the penile duplex sonography indicated a leak so I guess its all about finding the offending vein/veins and hope they travel straight to my prostate; if not there is nothing they can do and I go for the implant option which will be ok knowing I have explored everything else known to modern medicine.

Was thinking about the success rate at 77% which includes the 14% that although not totally cured respond better to PD5's. I have responded well in the main to the strongest dose of Viagra and Cialis but I this is now waning so if at best if regain powerful erections taking a lower dose I will be happy. As for the poor guys in the 23% no betterment bracket I wonder if this includes the 10% or so that have abnormal outflow I.e. leaky veins that bypass the prostate? In addition I guess that many of the others have further underlying physical issues working against them which maybe worse than any venous leak they may have?

Positive mental attitude is the key and I need to forget the downsides and focus on finally beating my venous leak.

Gollam121