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For example, I guess it can play a role in confirming a venous leak. But then what? What doors open or close after the results of the ultrasound?

An ultrasound won't really steer your treatment course too much. We are all different but the path is kind of the same. Oral medication ->VED/Ring, Injections then an Implant when all else fails.

I had the same question not long ago as this is my first year of using trimix. I would hear of guys on these forums going to urologists ran a bill of anywhere from $600 to $2000 (this is before insurance or Medicare), and would get a "workup", an ultrasound, or doppler, or whatever. Then, once that was over, the urologist would most often give their penis a huge shot of trimix and "judge" the reaction. A couple of guys on a different forum actually ended up having to go to the ER from the shot from the urologist. Nightmarish.

In my case, I had already been using different combinations of Viagra, Levitra, Cialis, arginine/citrulline, and even Yohimbine. I knew the trimix was next as the just mentioned drugs were not working well anymore. I'm pretty sure I have a venous leak. But does that really matter? The urologist would just try a trimix shot anyway. And I know I wanted to do something about my ED.

I had the mind that if anyone was going to inject my penis, it would be ONLY me. And that I wanted to start out with a tiny dose of trimix, and carefully work my way up. I don't like losing control, and going to a urologist would be at a disadvantage for sure.

So, I just used Olympia Pharmacy and their telemed doctor. I'm very happy. I injected myself, and still do. There is also RXBuyersClub as well. Both are excellent.