Venous Leak Demystification

[edjohn]

I want to share something I've stumbled on because I've seen a lot of descriptions of venous leak which seem misguided or based on incorrect assumptions.

In my interpretation, venous leak simply means a failure of the erectile system as a whole, which presents as greater-than-desired outflow, but but is not technically a leak but a failure of the geometry of the tissues to occlude these veins sufficiently. See this Japanese study which explains this:

THE MECHANISM OF BLOOD OUTFLOW FROM THE CAVERNOUS TISSUE OF HUMAN PENIS BY COMPUTER GRAPHICS
https://www.jstage.jst.go.jp/article/jp ... 2/_article

The researchers "were unable to find any valves in the blood outflow system" and if one understands the function of veins, it is to bring blood back to the heart not hold it away from the heart, thus any venous valves would not be expected to serve in any capacity supporting erections.

They concluded that "the arterial system plays a main role, and the venous system a secondary role, in controlling the human penile erection", in other words, the sole determinant of erection is the ability to achieve sufficient blood in-flow, i.e. above "the maintenance rate".

In my opinion, while occluding veins by surgical methods may improve this ratio of in to out, the primary goal in ED cases should be to maximize arterial function and the health of the circulatory system, regardless of whether one's condition is considered "venous leak" or not.

[TwoStep]

The researchers "were unable to find any valves in the blood outflow system" and if one understands the function of veins, it is to bring blood back to the heart not hold it away from the heart, thus any venous valves would not be expected to serve in any capacity supporting erections.

They concluded that "the arterial system plays a main role, and the venous system a secondary role, in controlling the human penile erection",

This part is true (if you count the corpora with the arterial system) and it seems that the paper you shared was an early one to figure that out.

But what it doesn’t mention is that the expansion during erection causes the venous return flow to be restricted because the veins are on the outside and they get squeezed when the corpora expand. Maybe the paper you shared was part of the progress that later helped people figure this out.

This also means that, for responders, viagra and injections can temporarily close the “venous leak”.

[edjohn]

The way I read it, it is this portion from paragraph two where they imply this mechanism:

When blood flows into the corpus cavernosum penis at a flow rate greater than usual, the volume of the corpus cavernosum penis increases, the veins running immediately below the tunica albuginea are compressed between the cavernous space and the tunica albuginea, the tunica albuginea extends, and the veins running inside the tunica albuginea are compressed, causing a disturbance in blood outflow and resulting in erection.

In the end I think it's just important that people don't feel specifically left out or unheard because their issue is a "leak". In some sense, everyone suffering from ED experiences leak. So we can all benefit from focusing on improving circulation rather than worrying about some mysterious valve issue we think few people understand.