FrankTalk.org

Hello,

I am a friend of s7utty who was kind enough to lend me his account as it is impossible for me to create a new one.

I'm writing this post because I'm very concerned about the way erectile dysfunction is being managed and discussed with young and healthy males. I see that many young individuals, with mild to moderate dysfunction, are diagnosed with "venous leaks" by Doppler examination. “Venous leak” is a very serious diagnosis that have a huge impact on these poor young people, most of whom have a dominant psychogenic cause for their ED.

In addition to numerous studies demonstrating the inaccuracy of Doppler tests, a recent study on a group of 302 young men with confirmed “venous leak” diagnosed by doppler ultrasound, showed that over 98% of them had no leakage after either repeating the Doppler test 3 times or undergoing sex therapy and repeating the Doppler test 2 times. The reason for these false diagnoses is that anxiety prevents the complete relaxation of the smooth muscle, which causes incomplete erection and thus non-functioning of the veno-occlusive mechanism, mimicking a venous leak on Doppler examination.

However, for 98% of the subjects studied, when anxiety is reduced (by repeating the doppler multiple times and with psychosexual therapy), and the smooth muscle relaxes completely, a full erection is achieved and the Doppler no longer shows a venous leak, hence the reason why some “venous leakers” have inconsistent erections (i.e. they can be very good sometimes, sometimes not).

https://pubmed.ncbi.nlm.nih.gov/29155195/

I am very disappointed to see the ignorance on this site regarding psychogenic erectile dysfunction. When we talk about a psychological cause, we're not just talking about "not being in the moment", it’s not only in the head, anxiety does have an organic and chemical impact on the relaxation of the smooth muscle of the penis. This is also demonstrated in the following study :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837321/

So PLEASE, young people, if you're healthy and have inconsistent erections, please don't listen to the incompetent urologists who give you this dubious and simplistic diagnosis called "venous leak". Get a second and a third opinion. Don’t listen to the eldery on this forum who push implants as magic solution. Ask yourself the following questions : was I fully hard during the doppler exam ? Was the erection during the exam at least equivalent to the one I get home ? If the answer is no, then the exam is garbage, just google “false venous leak” and read the stufies. If you can get and maintain a complete erection under some circonstances, you don’t have a fkn hole in your penis. You should work on anxiety management in order to to optimize the functioning of oral treatments (because yes, your psychogenic ED can counter the effect of the strongest dose of viagra, as you can see in the first study that I linked).

Peace.

I think your manifesto makes some good points, however the first study you referred to uses a vasodilator to cause an erection. Many men with ED are aided by vasodilators and other types of injections to achieve an erection. The purpose of this forum is to provide education so that each individual can make their own choices. I have read the entire forum and while there are some, like myself that went through the pde5 success and then failure as well as injection failures followed by a very successful implant, that recommend an implant with a good surgeon as a great choice. The best answer IHO is to seek out a competent physician and chart one’s own best course. In my case I would have been better off having my implant much earlier in life than later. Regardless of the results of a leakage test, if one can’t achieve an erection the test doesn’t matter. I think that to just says that venous leakage is BS based on a 300-person study may not be correct. A google will produce many studies that seemly contradict each other in both directions. Venous leakage or supposed venous leakage is frequently overcome with injections or use of rings etc. which slowdown outgoing blood flow, what does that mean?
Psychogenic ED can be very complicated to deal with especially if it is combined with physical issues too.
I think what the first study really said was that counseling was a good thing to try.

s7utty wrote:Hello,

I am a friend of s7utty who was kind enough to lend me his account as it is impossible for me to create a new one.

I'm writing this post because I'm very concerned about the way erectile dysfunction is being managed and discussed with young and healthy males. I see that many young individuals, with mild to moderate dysfunction, are diagnosed with "venous leaks" by Doppler examination. “Venous leak” is a very serious diagnosis that have a huge impact on these poor young people, most of whom have a dominant psychogenic cause for their ED.

In addition to numerous studies demonstrating the inaccuracy of Doppler tests, a recent study on a group of 302 young men with confirmed “venous leak” diagnosed by doppler ultrasound, showed that over 98% of them had no leakage after either repeating the Doppler test 3 times or undergoing sex therapy and repeating the Doppler test 2 times. The reason for these false diagnoses is that anxiety prevents the complete relaxation of the smooth muscle, which causes incomplete erection and thus non-functioning of the veno-occlusive mechanism, mimicking a venous leak on Doppler examination.

However, for 98% of the subjects studied, when anxiety is reduced (by repeating the doppler multiple times and with psychosexual therapy), and the smooth muscle relaxes completely, a full erection is achieved and the Doppler no longer shows a venous leak, hence the reason why some “venous leakers” have inconsistent erections (i.e. they can be very good sometimes, sometimes not).

https://pubmed.ncbi.nlm.nih.gov/29155195/

I am very disappointed to see the ignorance on this site regarding psychogenic erectile dysfunction. When we talk about a psychological cause, we're not just talking about "not being in the moment", it’s not only in the head, anxiety does have an organic and chemical impact on the relaxation of the smooth muscle of the penis. This is also demonstrated in the following study :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837321/

So PLEASE, young people, if you're healthy and have inconsistent erections, please don't listen to the incompetent urologists who give you this dubious and simplistic diagnosis called "venous leak". Get a second and a third opinion. Don’t listen to the eldery on this forum who push implants as magic solution. Ask yourself the following questions : was I fully hard during the doppler exam ? Was the erection during the exam at least equivalent to the one I get home ? If the answer is no, then the exam is garbage, just google “false venous leak” and read the stufies. If you can get and maintain a complete erection under some circonstances, you don’t have a fkn hole in your penis. You should work on anxiety management in order to to optimize the functioning of oral treatments (because yes, your psychogenic ED can counter the effect of the strongest dose of viagra, as you can see in the first study that I linked).

Peace.

Hola yo realice eco dopler con caverjet 20 mcg y me dio priapismo y debieron drenarme. Tengo miedo que el priapismo me haya provocado una fibrosis interna y difusion erectil.

biobob wrote:I think your manifesto makes some good points, however the first study you referred to uses a vasodilator to cause an erection. Many men with ED are aided by vasodilators and other types of injections to achieve an erection. The purpose of this forum is to provide education so that each individual can make their own choices. I have read the entire forum and while there are some, like myself that went through the pde5 success and then failure as well as injection failures followed by a very successful implant, that recommend an implant with a good surgeon as a great choice. The best answer IHO is to seek out a competent physician and chart one’s own best course. In my case I would have been better off having my implant much earlier in life than later. Regardless of the results of a leakage test, if one can’t achieve an erection the test doesn’t matter. I think that to just says that venous leakage is BS based on a 300-person study may not be correct. A google will produce many studies that seemly contradict each other in both directions. Venous leakage or supposed venous leakage is frequently overcome with injections or use of rings etc. which slowdown outgoing blood flow, what does that mean?
Psychogenic ED can be very complicated to deal with especially if it is combined with physical issues too.
I think what the first study really said was that counseling was a good thing to try.

I’m not saying venous leak is bullshit, please think outside the box. A true “venous leak” happens when the penis is not able to retain blood even when fully erect. In young and healthy men this can be due to congenital issues or trauma, but it’s pretty rare.

The problem with dopplers is that they assume full smooth muscle relaxation, however if you’re very anxious your penis won’t be fully erect so the blood will keep leaking because the veins are not fully compressed. If you read the full text of the study, you’ll understand how they came to the conclusion that psychogenic ED can be so strong that it can have a direct chemical impact on the ability of the penis to fully expand and activate the veno-occlusive mechanism. I can share the full text if you wish.

For most young men, the pattern is the following : they fail in bed due to psychogenic ED / they freak out that they may have a physical issue / they try to get hard with porn to see if they are ok, they fail because of anxiety and poor stimulation / they forget about all the times they had strong erections because the mind is so negative / they go to the urologist and ask for a doppler / they get diagnosed with venous leak / they are convinced their life is over and the implant is the only solution.

Again, I’m not saying there isn’t cases with congenital issues where the penis is just inable to hold the blood, but in most cases, young men have issues with smooth muscle relaxation and counseling combined with adequate use of pde5i could be enough to treat the problem. Here’s the conclusion of the study I’m talking about :

It is not surprising that anxiety generates ED via CVOD. The main mediator of organic response vs anxiety is (nor- )adrenaline; (nor-)adrenaline concentration and its recep- tors increase during anxiety. Penile erection is achieved by cavernosal smooth muscle relaxation, and nitric oxide (NO) is the main mediator. Nerve- and endothelium- released NO target soluble guanylyl cyclase in the corpus cavernosum, thus increasing cyclic guanosine monophos- phate (cGMP) levels which activate protein kinase G (PKG). Activated PKG decreases intracellular levels of calcium, causing smooth muscle relaxation. The penis is kept flaccid by adrenergic activation and, in the absence of an active NO/cyclic guanosine monophosphate pathway, the cavernosal smooth muscle remains in the contracted state. This is mediated by the effects of (nor-)adrenaline released by the sympathetic nerves, and prostaglandin F2α from the endothelium by means of increasing intracellu- lar calcium concentration. In addition, the RhoA/Rho- kinase pathway contributes to maintaining penile flaccidity. RhoA/Rho-kinase is upregulated in ED and by (nor-)adrenaline. Contraction or absence of relaxation of the cavernous tissue is the final pathway of anxiety, which
causes blood to escape, and a high EDV, that is, CVOD and ED.
The diagnosis of psychogenic ED instead of CVOD is critical. Psychological therapy or the administration of PDEi + alpha-lytic drugs (which increase the efficacy of PDE5i for psychogenic ED) should be offered as first- line treatments.

s7utty wrote:Hello,

I am a friend of s7utty who was kind enough to lend me his account as it is impossible for me to create a new one.

I'm writing this post because I'm very concerned about the way erectile dysfunction is being managed and discussed with young and healthy males. I see that many young individuals, with mild to moderate dysfunction, are diagnosed with "venous leaks" by Doppler examination. “Venous leak” is a very serious diagnosis that have a huge impact on these poor young people, most of whom have a dominant psychogenic cause for their ED.

In addition to numerous studies demonstrating the inaccuracy of Doppler tests, a recent study on a group of 302 young men with confirmed “venous leak” diagnosed by doppler ultrasound, showed that over 98% of them had no leakage after either repeating the Doppler test 3 times or undergoing sex therapy and repeating the Doppler test 2 times. The reason for these false diagnoses is that anxiety prevents the complete relaxation of the smooth muscle, which causes incomplete erection and thus non-functioning of the veno-occlusive mechanism, mimicking a venous leak on Doppler examination.

However, for 98% of the subjects studied, when anxiety is reduced (by repeating the doppler multiple times and with psychosexual therapy), and the smooth muscle relaxes completely, a full erection is achieved and the Doppler no longer shows a venous leak, hence the reason why some “venous leakers” have inconsistent erections (i.e. they can be very good sometimes, sometimes not).

https://pubmed.ncbi.nlm.nih.gov/29155195/

I am very disappointed to see the ignorance on this site regarding psychogenic erectile dysfunction. When we talk about a psychological cause, we're not just talking about "not being in the moment", it’s not only in the head, anxiety does have an organic and chemical impact on the relaxation of the smooth muscle of the penis. This is also demonstrated in the following study :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837321/

So PLEASE, young people, if you're healthy and have inconsistent erections, please don't listen to the incompetent urologists who give you this dubious and simplistic diagnosis called "venous leak". Get a second and a third opinion. Don’t listen to the eldery on this forum who push implants as magic solution. Ask yourself the following questions : was I fully hard during the doppler exam ? Was the erection during the exam at least equivalent to the one I get home ? If the answer is no, then the exam is garbage, just google “false venous leak” and read the stufies. If you can get and maintain a complete erection under some circonstances, you don’t have a fkn hole in your penis. You should work on anxiety management in order to to optimize the functioning of oral treatments (because yes, your psychogenic ED can counter the effect of the strongest dose of viagra, as you can see in the first study that I linked).

Peace.

A ti te dio priapismo en un estudio? Que te dijo el medico no causaria daños?

Bambino09 wrote:

s7utty wrote:Hello,

I am a friend of s7utty who was kind enough to lend me his account as it is impossible for me to create a new one.

I'm writing this post because I'm very concerned about the way erectile dysfunction is being managed and discussed with young and healthy males. I see that many young individuals, with mild to moderate dysfunction, are diagnosed with "venous leaks" by Doppler examination. “Venous leak” is a very serious diagnosis that have a huge impact on these poor young people, most of whom have a dominant psychogenic cause for their ED.

In addition to numerous studies demonstrating the inaccuracy of Doppler tests, a recent study on a group of 302 young men with confirmed “venous leak” diagnosed by doppler ultrasound, showed that over 98% of them had no leakage after either repeating the Doppler test 3 times or undergoing sex therapy and repeating the Doppler test 2 times. The reason for these false diagnoses is that anxiety prevents the complete relaxation of the smooth muscle, which causes incomplete erection and thus non-functioning of the veno-occlusive mechanism, mimicking a venous leak on Doppler examination.

However, for 98% of the subjects studied, when anxiety is reduced (by repeating the doppler multiple times and with psychosexual therapy), and the smooth muscle relaxes completely, a full erection is achieved and the Doppler no longer shows a venous leak, hence the reason why some “venous leakers” have inconsistent erections (i.e. they can be very good sometimes, sometimes not).

https://pubmed.ncbi.nlm.nih.gov/29155195/

I am very disappointed to see the ignorance on this site regarding psychogenic erectile dysfunction. When we talk about a psychological cause, we're not just talking about "not being in the moment", it’s not only in the head, anxiety does have an organic and chemical impact on the relaxation of the smooth muscle of the penis. This is also demonstrated in the following study :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837321/

So PLEASE, young people, if you're healthy and have inconsistent erections, please don't listen to the incompetent urologists who give you this dubious and simplistic diagnosis called "venous leak". Get a second and a third opinion. Don’t listen to the eldery on this forum who push implants as magic solution. Ask yourself the following questions : was I fully hard during the doppler exam ? Was the erection during the exam at least equivalent to the one I get home ? If the answer is no, then the exam is garbage, just google “false venous leak” and read the stufies. If you can get and maintain a complete erection under some circonstances, you don’t have a fkn hole in your penis. You should work on anxiety management in order to to optimize the functioning of oral treatments (because yes, your psychogenic ED can counter the effect of the strongest dose of viagra, as you can see in the first study that I linked).

Peace.

A ti te dio priapismo en un estudio? Que te dijo el medico no causaria daños?

I don’t speak spanish man, you can use google translate.

s7utty wrote:

Bambino09 wrote:

s7utty wrote:Hello,

I am a friend of s7utty who was kind enough to lend me his account as it is impossible for me to create a new one.

I'm writing this post because I'm very concerned about the way erectile dysfunction is being managed and discussed with young and healthy males. I see that many young individuals, with mild to moderate dysfunction, are diagnosed with "venous leaks" by Doppler examination. “Venous leak” is a very serious diagnosis that have a huge impact on these poor young people, most of whom have a dominant psychogenic cause for their ED.

In addition to numerous studies demonstrating the inaccuracy of Doppler tests, a recent study on a group of 302 young men with confirmed “venous leak” diagnosed by doppler ultrasound, showed that over 98% of them had no leakage after either repeating the Doppler test 3 times or undergoing sex therapy and repeating the Doppler test 2 times. The reason for these false diagnoses is that anxiety prevents the complete relaxation of the smooth muscle, which causes incomplete erection and thus non-functioning of the veno-occlusive mechanism, mimicking a venous leak on Doppler examination.

However, for 98% of the subjects studied, when anxiety is reduced (by repeating the doppler multiple times and with psychosexual therapy), and the smooth muscle relaxes completely, a full erection is achieved and the Doppler no longer shows a venous leak, hence the reason why some “venous leakers” have inconsistent erections (i.e. they can be very good sometimes, sometimes not).

https://pubmed.ncbi.nlm.nih.gov/29155195/

I am very disappointed to see the ignorance on this site regarding psychogenic erectile dysfunction. When we talk about a psychological cause, we're not just talking about "not being in the moment", it’s not only in the head, anxiety does have an organic and chemical impact on the relaxation of the smooth muscle of the penis. This is also demonstrated in the following study :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837321/

So PLEASE, young people, if you're healthy and have inconsistent erections, please don't listen to the incompetent urologists who give you this dubious and simplistic diagnosis called "venous leak". Get a second and a third opinion. Don’t listen to the eldery on this forum who push implants as magic solution. Ask yourself the following questions : was I fully hard during the doppler exam ? Was the erection during the exam at least equivalent to the one I get home ? If the answer is no, then the exam is garbage, just google “false venous leak” and read the stufies. If you can get and maintain a complete erection under some circonstances, you don’t have a fkn hole in your penis. You should work on anxiety management in order to to optimize the functioning of oral treatments (because yes, your psychogenic ED can counter the effect of the strongest dose of viagra, as you can see in the first study that I linked).

Peace.

A ti te dio priapismo en un estudio? Que te dijo el medico no causaria daños?

I don’t speak spanish man, you can use google translate.

Did you have a Dopler ultrasound? did you get priapism? Did your doctor not warn you of possible diffusion after drainage? Same thing happened to me

Did you have a Dopler ultrasound? Did you have priapism? Did your doctor not warn you about possible spread after drainage? Same thing happened to me

Therapy not always work, if you had anxiety for years and a lack of relationships, is almost impossible to fix that if anything it gets worse with time

Much more with aging

If you can get hard alone or porn then your ed is mental it doesn’t matter if your erection doesn’t lasy long with porn maybe it doesn’t turn you in anymore

Ir maybe even when alone you start to feel anxious now