https://journals.sagepub.com/doi/full/1 ... 5819847318
Veno-occlusive dysfunction resulting in ED remains under-researched with a poor-quality evidence base and whilst undoubtedly a definite clinical entity, there remains a significant number of unanswered questions at all stages of the patient pathway.
Investigations are hindered by the inability to account for varying degrees of arterial insufficiency and by the potential presence of minor but still significant venous leak sites undetectable in the presence of a greater leak. Whilst an attempt at diagnostic standardisation has been made, reliable reproducibility is yet to be achieved and the true aetiology in most cases remains elusive.
Effective management options are based on resection or ligation of the offending venous drainage with a significant decline in efficacy with follow-up exceeding 12 months, perhaps as a consequence of collateral drainage.
It is likely that veno-occlusive dysfunction represents a spectrum of severity, the assumption being that there is a critical level of dysfunction, probably related in part to arterial inflow integrity and penile volumetric change with tumescence at which a patient becomes symptomatic. This would indicate that at greater degrees of arterial insufficiency, a lesser degree of veno-occlusive dysfunction would yield ED than would be required in the presence of adequate arterial inflow.
So, if you want to look at my other post I made yesterday, I was diagnosed with a venous leak but pills still work for me most of the time. It really depends on my mood. I've also read on this site and many other places that men say pills work for them despite being diagnosed with a venous leak. Venous leaks also have a 50% false positive diagnosis (the articles are linked in my other post). As that article outlines, every test they have for them has issues and men that were previously diagnosed via whatever method are later cleared. So much of this is just anxiety triggering a "venous leak". It probably mostly comes down to performance anxiety for most men.
I really think they need to stop diagnosing this shit until they have a better understanding of it because it wreaks havoc on men that get diagnosed with it. I've been staring into the abyss.
