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***Endovacular Repair Of Venous Leak My Story***

Viagra and Cialis stoped working for me a little over a year ago. At that point my urologist finally did a Doppler. It showed a severe venous leak. The only treatment offered was injections then implant when those stopped working.

I spent countless hours searching for answers at that point. Looking at clinical trials all sorts of stuff. The only thing that sounded promising in my research was endovascular repair of venous leak by interventional radiology. The fact that they are experts of the vascular system and the procedure is minimally invasive made up my mind. My thoughts were why sit back and let this progress to needing an implant.

Finally I found a doctor that is an interventional radiologist far from where I live. I did a video consult and everything seemed great he is having very good success rates at repairing venous leaks. Not everyone had 100 percent recovery but most experienced improvements. So after my video consult I scheduled an appointment for the procedure.

2/3/22 I flew to this doctor and he is very reputable. He works at a university hospital and is a top rated interventional radiologist.

2/4/22 was my scheduled procedure date. Pre procedure he wanted to do an ultrasound to confirm venous leak because it had been over 1 year. Ultrasound showed no leak. So he had already planned a CT scan. CT scan provides the most definitive diagnosis of venous leak.

My CT scan results showed zero leak! Arterial function was great and venous function perfect.

This was so disappointing because I have no answers. Now I do not know the cause of ED at all. My testosterone was slightly borderline and I have improved that to normal functioning level. My ED is not psychological as I can’t get an erection what so ever even by myself. I definitely feel defeated by ED at this point. All of my symptoms mimic venous leak almost perfectly. I can get maybe a 75 percent election laying on my back without medication. Any movement of stopping of stimulation and I lose it quickly. The only medication that works at this point is trimix. I’ve tried viagra, cialis, levitra and none of it works. I’m not on any medications either that would cause ED.

Can anyone recommend a decent urologist in Michigan?

That stinks. Trimix usually works even with a venous leak, but the effects may lessen over time. When I used Trimix it worked good for me for about 2-3 years then began to fail. The hassle was having to jump out of bed to go inject.
Something does sound screwy though. Why did an Ultrasound show a venous leak and then one year later no leak? And of course, no change to your erections. I'm not sure why you are having this problem.
Don't know any docs up in Michigan, but my doc in Ohio was good. PM me if you want his name.

jwpenn82 wrote:***Endovacular Repair Of Venous Leak My Story***

Viagra and Cialis stoped working for me a little over a year ago. At that point my urologist finally did a Doppler. It showed a severe venous leak. The only treatment offered was injections then implant when those stopped working.

I spent countless hours searching for answers at that point. Looking at clinical trials all sorts of stuff. The only thing that sounded promising in my research was endovascular repair of venous leak by interventional radiology. The fact that they are experts of the vascular system and the procedure is minimally invasive made up my mind. My thoughts were why sit back and let this progress to needing an implant.

Finally I found a doctor that is an interventional radiologist far from where I live. I did a video consult and everything seemed great he is having very good success rates at repairing venous leaks. Not everyone had 100 percent recovery but most experienced improvements. So after my video consult I scheduled an appointment for the procedure.

2/3/22 I flew to this doctor and he is very reputable. He works at a university hospital and is a top rated interventional radiologist.

2/4/22 was my scheduled procedure date. Pre procedure he wanted to do an ultrasound to confirm venous leak because it had been over 1 year. Ultrasound showed no leak. So he had already planned a CT scan. CT scan provides the most definitive diagnosis of venous leak.

My CT scan results showed zero leak! Arterial function was great and venous function perfect.

This was so disappointing because I have no answers. Now I do not know the cause of ED at all. My testosterone was slightly borderline and I have improved that to normal functioning level. My ED is not psychological as I can’t get an erection what so ever even by myself. I definitely feel defeated by ED at this point. All of my symptoms mimic venous leak almost perfectly. I can get maybe a 75 percent election laying on my back without medication. Any movement of stopping of stimulation and I lose it quickly. The only medication that works at this point is trimix. I’ve tried viagra, cialis, levitra and none of it works. I’m not on any medications either that would cause ED.

Can anyone recommend a decent urologist in Michigan?

Just curios. How old are you and how long was it before cialis and Viagra stopped working for you?

I’m 39 now. Oral meds quite working after 2 years or so. I’ve been on trimix for a year.

jwpenn82 wrote:I’m 39 now. Oral meds quite working after 2 years or so. I’ve been on trimix for a year.

I'm sorry to hear mate.
This is horrible. Can you not get another doppler to confirm anythijg with 2 showing different things?

CT scan showed no leak which is more definitive than a Doppler. Also I had a Doppler just before CT scan and it showed no leak. I have no idea what to do next

jwpenn82 wrote:CT scan showed no leak which is more definitive than a Doppler. Also I had a Doppler just before CT scan and it showed no leak. I have no idea what to do next

Have you had any bloodwork done at all?
Any diabetes?
Do you get any morning wood at all?

Gavalar09 wrote:

jwpenn82 wrote:CT scan showed no leak which is more definitive than a Doppler. Also I had a Doppler just before CT scan and it showed no leak. I have no idea what to do next

Have you had any bloodwork done at all?
Any diabetes?
Do you get any morning wood at all?

Yes I had blood work no diabetes. All of my lab work checked out fine. My testosterone was borderline. My urologist said I could try clomid to boost my testosterone a little. Currently I’m on clomid and have been for almost a year. Testosterone levels are great now. All other lab work checks out good.

jwpenn82 wrote:

Gavalar09 wrote:

jwpenn82 wrote:CT scan showed no leak which is more definitive than a Doppler. Also I had a Doppler just before CT scan and it showed no leak. I have no idea what to do next

Have you had any bloodwork done at all?
Any diabetes?
Do you get any morning wood at all?

Yes I had blood work no diabetes. All of my lab work checked out fine. My testosterone was borderline. My urologist said I could try clomid to boost my testosterone a little. Currently I’m on clomid and have been for almost a year. Testosterone levels are great now. All other lab work checks out good.

Pelvic floor maybe?
Do you kegel at all?

jwpenn82 wrote:

Gavalar09 wrote:

jwpenn82 wrote:CT scan showed no leak which is more definitive than a Doppler. Also I had a Doppler just before CT scan and it showed no leak. I have no idea what to do next

Have you had any bloodwork done at all?
Any diabetes?
Do you get any morning wood at all?

Yes I had blood work no diabetes. All of my lab work checked out fine. My testosterone was borderline. My urologist said I could try clomid to boost my testosterone a little. Currently I’m on clomid and have been for almost a year. Testosterone levels are great now. All other lab work checks out good.

I have come to the understanding that dopplers will only show a limited amount of reasons why erectile dysfunction may be present and they can be fallible. Even the other tests you have had done (which are more detailed) do not show many of the reasons why a venous leak can occur. The reason for this is that the IC injection you receive to force an erection, by passes many of the micro process that need to happen to enable erectile function. Many of these micro processes if dysfunctional can cause a venous leak. A venous leak is generally not one, two or three small leaks, it can be hundreds if not more as it can be caused by the inability of the corpus cavernosum to expand sufficiently to effectively seal at the tunica. I wrote an in-depth post on this and the general misunderstanding of what a venous leak can be.
The IC injection itself can hide a malfunction in the process of venous occlusion.

It appears that you have been diagnosed with low T. Therefore hormonal disruption could be the cause of your ED. I see you are being treated with the use of Clomid. Clomid is very good at getting your T levels up, no doubt. However, it is also very good at causing sexual dysfunction in many men. This is because it not only blocks the estrogen receptor in some tissues but it can also stimulate the estrogen receptor in others. Many guys whilst on Clomid can have erectile function issues. A year on this drug is what I would consider long term and it appears your doctor is using it as a form of HRT rather than short term usage to give the HPTA a kick start. Long term usage of Clomid can cause many side effects and is not a very good form of HRT. My advice is to not use a urologist for hormone issues.
Your T numbers as you put it may be good, but any good effects from this improved level of T may be getting stymied by the estrogenic effects of Clomid. An aromatase inhibitor will not work in this case either.
As your T was borderline before Clomid use it may have improved with a restart protocol, depending on your age, state of health and fitness.
Any hormone issues should preclude any form of surgery to fix a suspected venous leak IMO.

Do you have nocturnal erections and if not how long have they been absent?

The big problem with low testosterone causing ED is that trying to remedy ED with supplemental testosterone rarely fixes the issue. The reasons for this are complex and are mainly concerned with the inadequacies of T replacement protocols currently available. This is why many men on TRT usually depend on some form of erectile enhancement ranging from PDE5i all the way up to an implant.