Dr. Ralf Herwig claims that he cures Venous Leak

[AVL_UK]

Had doppler before, showed some venous leak, but wasn't very erect when they did the procedure.

My local urology unit does a pelvic angiogram as well, think it's worth doing? Anyone had it done? Ideally I want them to find an actual problem from my initial injury that would be the underlying cause of my ED. Then I can focus on possibly getting that repaired if possible.

Money isn't a problem, so no need to argue about that folks! Thank you to Alibaba for previous answer.

[PFracture]

If money is no issue, you should go to a particular doctor in the US, to fully assess your condition. The only practice i know of, focused only on sexual medicine and specifically injuries. Super close to the airport. After having the diagnostics, if you don't like their experience, you can go somewhere else...

[defiant]

Hello everyone,

I've been following this and other threads for some time with great interest. I used to be active on other boards but wanted to escape it all but now I want to share my story again.

I'm 32 and live in London. About 10 years ago I began to notice that my erection quality was deteriorating and suffered a particularly bad experience with a girl that truly and profoundly knocked my confidence. Since that time I have experienced huge and increasing psychological pressure to perform.

The psychological component of ED is MASSIVE and cannot be understated. Erections are a truly mind-body process which are reliant on sufficient 'signal' as one urologist I have consulted calls it. The psychological pressure to perform inhibits EQ because your body enters 'fight or flight' mode, aka the Stress Response. This is the release of hormones which severely inhibit EQ. I know I am preaching to the choir here but I just want to stress how much this impacts EQ. Processes such as digestion, sleep and arousal are all best achieved in relaxed states. Psychogenic factors severely compound this horrifying problem.

Now, about me:

32
ED worsening for 10 years
Lymphoma diagnosed and bested with chemo and stem cells 5 years ago
Post lymphoma - visited urologists
Doppler US performed - 'Minor venous leak found to be the cause of ED'
Decent inflow, poor outflow
Cialis 5mg prescribed - worked extremely well (rockstar levels) - at this point could still perform well enough without
Relationship ended, needed to be assured performance due to innate fear with next girl
Thus reinforcing dependence on pills
Sought second US with phentolomine for nerves - similar result - VL confirmed
Continued to use Cialis 5mg to good effect whenever needed with fluctuating periods of 'will it work as well this time round' to periods of assuredness in the medication when settled with a girl
VL got to me mentally, sought a consultation with a prominent London based sexual medicine team on Harley St
With no trauma evident they suspected psychogenic ED
Doppler US performed - THIS TIME I WAS TOLD TO MASSAGE THE PENIS AFTER INJECTION
FURTHERMORE during the test I would intermittently touch my penis
I worried the touching had violated fair test conditions - I was assured that not only did this NOT violate fair test conditions, it was desired.
Results: EXCELLENT INFLOW, huge PSV. Negative outflow. No VL found.
Told by the team that this was very likely psychogenic in nature. Suggested to continue cialis with partners that are understanding until such time I forget to take a pill and realise it still works well without.
Did this....
ED has continued. Psychological dependence on Cialis has increased.
I haven't had morning erections in years. Once in a blue moon.
Night erections that I notice are few and far between
Masturbation requires constant stimulation - I will lose full rigidity in a matter or 5-10 seconds
And now....I feel as though the effects of Cialis are waning.
Morning sex with a dose of Cialis the night before will result in my losing erection in minutes
ALL THE WHILE MY MIND IS RACING SO WHAT CHANCE DO I HAVE?! You MUST be TURNED ON, NOT SCARED.

I am truly scared Cialis will stop working for me one day. I don't want that.

I am still confused as to whether I even have a problem physically. I must do with no morning wood and two positive US tests.

The one negative test with excellent results however was with sexual medicine specialists. Thus contributing to my confusion. Do I have VL?! Don't I?! Either way, my dick won't work without PDE-5s. Well, sometimes in the heat of the moment I can perform without when my mind is settled and I'm horny as hell.

The sexual medicine specialist said VL is a term banded about too much. That VL is merely the natural detumescence of a penis. Of course VL exists but without clear trauma or congenital causes, the likely hood a man could develop a leak is very low. This in concert with my excellent test results led him to diagnose me with severe psychological ED, caused by a single incidence of failure to perform, compounded by reliance on drugs over the years.

So, where do I go from here? Continue to use drugs. Fine. People take statins daily. I'm no where near as worse off as some brave souls on here, God bless you all! I've even beaten cancer.

But what happens when Cialis stops working?! Do I seek this sclerotherapy. Does it even work. Is it a long term solution. What are the negative impacts. Can it be trusted. Is is peer-reviewed (I'm sure it is).

I am not at the point where I feel I need to seek surgery. But, if Cialis abandons me one day, which I feel as though it is doing, I might have to seek help.

At this point I'm still unsure as to whether I even have VL BUT, with very poor EQ and ZERO morning erections, I am forced to consider the sexual medicine specialist US a spurious result and side with NHS urologists that I do indeed have VL.

Questions:

How badly does your psych element affect you?
Does touching yourself during a Doppler US invalidate the result?
Does VL worsen?
Seeking, Razor - where are you??????? Please update us!

Pleasure to join the community!

[merrix]

How bad does (did) the psych element affect me?
Well, how does anyone really know?
If the dick goes soft due to blood leaking out or due to psychological reasons, how can you tell?
I think it is fair to say that in basically every case of a physical reason for ED, it will be compounded by psychological issues as well.
But can you say some sort of proportion, as in the mental part is 30% and the physical is 70%? No, I don't think so.
For me though, I still believe in the old diagnosis of looking at masturbation and morning/nightly erections.
Maybe there can be severe cases where guys even have performance anxiety when jerking off, but barely when sleeping.
In my case, my dick either didn't even get really hard when masturbating, or it went soft within seconds if not keeping the action going.
I barely ever had morning wood, and if I did, it was most of the time a semi which went soft within seconds after waking up.

I did have a VL diagnosed by both Dr. Kuehhas and Dr. Eid. Both of them claiming it was 'huge'. Kuehhas claimed he fixed it with his sclero. And sure, for a few weeks I think I was actually fixed. I had super-hard nightly erections and great morning wood. I got spontaneous erections several times every day, and jerking off was a completely different story.
But that effect diminished after a couple of months. The improvement was still clearly there, but it was only that. An improvement, not a cure. Was it because of psychological reasons? Maybe Kuehhas fixed the physical problem, but I still had the mental? Who knows. And does anyone know that even VL is not psychological? When the anxiety sets in, how does the dick physically lose its erections? By blood leaking out? By what looks like a VL on a Doppler?
But for sure, Dr. Eid later diagnosed a 'huge' VL. And that was about 5 months after the sclero.

Now I don't give a F about psychology or pills anymore. I just pump my dick up and enjoy.
This is not to say though that I recommend anyone getting an implant. That's a beast itself, just a different beast. One that should not be taken lightly.
As you say, ED is not only about the dick, it is about the brain as well. And the implant will in most cases fix the dick, but there are no guarantees for the head. Poor confidence and obsessing over the dick can continue to cause problems.

[defiant]

How bad does (did) the psych element affect me?
Well, how does anyone really know?
If the dick goes soft due to blood leaking out or due to psychological reasons, how can you tell?
I think it is fair to say that in basically every case of a physical reason for ED, it will be compounded by psychological issues as well.
But can you say some sort of proportion, as in the mental part is 30% and the physical is 70%? No, I don't think so.
For me though, I still believe in the old diagnosis of looking at masturbation and morning/nightly erections.
Maybe there can be severe cases where guys even have performance anxiety when jerking off, but barely when sleeping.
In my case, my dick either didn't even get really hard when masturbating, or it went soft within seconds if not keeping the action going.
I barely ever had morning wood, and if I did, it was most of the time a semi which went soft within seconds after waking up.

I did have a VL diagnosed by both Dr. Kuehhas and Dr. Eid. Both of them claiming it was 'huge'. Kuehhas claimed he fixed it with his sclero. And sure, for a few weeks I think I was actually fixed. I had super-hard nightly erections and great morning wood. I got spontaneous erections several times every day, and jerking off was a completely different story.
But that effect diminished after a couple of months. The improvement was still clearly there, but it was only that. An improvement, not a cure. Was it because of psychological reasons? Maybe Kuehhas fixed the physical problem, but I still had the mental? Who knows. And does anyone know that even VL is not psychological? When the anxiety sets in, how does the dick physically lose its erections? By blood leaking out? By what looks like a VL on a Doppler?
But for sure, Dr. Eid later diagnosed a 'huge' VL. And that was about 5 months after the sclero.

Now I don't give a F about psychology or pills anymore. I just pump my dick up and enjoy.
This is not to say though that I recommend anyone getting an implant. That's a beast itself, just a different beast. One that should not be taken lightly.
As you say, ED is not only about the dick, it is about the brain as well. And the implant will in most cases fix the dick, but there are no guarantees for the head. Poor confidence and obsessing over the dick can continue to cause problems.

I commend you on your fight and brave decisions.

It really seems like VL is a downhill slope into hell.

Do you Merrix or anyone know if they typically worsen with age?

My function was perfect up until about 22/23 and now I can't really tell if my deterioration is due to a physical cause or more a gradual psychological battle. Of course the psychological component has increased over the years. Barring periods where I am stable with a woman and comfortable with them. I'm still without a stable girlfriend and thought I'd found the one recently but she has commitment issues at present.

The fact remains I still don't get morning wood and nocturnal erections (that I'm aware of) are few.

I recall no trauma so I cannot attribute this onset of VL to anything other than bad luck?! It really is baffling. To my knowledge, VL don't just come along out of nowhere for no good reason. All my bloods and hormone levels were normal.

Thankfully, it would seem there is still an array of medication orally, that I can utilise and varying dosages. I still can't believe the sexual medicine specialist thinks this is all in my head. It just can't be.

Do we know if the sclerotherapy has had lasting effects for anyone? As it is touted as being a cure. Perhaps it does work for some people, the anatomy and pathology in everyone is of course very different. Perhaps I should seek a consult with them.

[defiant]

Also Merrix,

You hint at masturbation being a good tool to rule out psych impact.

For me, I have viewed even masturbation as a test and have had a constant battle in my mind each time. 'Will it? Won't it?' Of course leading to a less than perfect set of conditions for arousal and thus a less than perfect erection.

I am never 100% relaxed and mentally aroused, free of stress whenever I do anything sexual, with someone else or alone.

[AVL_UK]

Has it been consistent for you? If you even get it up 1/10 times fine without pills, I would lean to thinking you don't have a physical problem, as physical would be there all the time? I haven't had an erection naturally by myself for over 2 years, whether I'm alone, upon waking or with a hot girl. Mine is also position dependant, better lying on my right side and in missionary. As it effects more CS than CC, you would think psychogenic would effect everything in one go. It is frustrating to know how much is psychological.

[defiant]

So do we have any information pertaining to those who underwent the surgery?

I know from reading that results were mixed with some experiencing no improvement at all.

Though Razor and Oxford seemed to have marked improvements with Razor reporting no leak at the 6 month mark.

Obviously with vastly different pathologies and anatomies we will all have differing outcomes. I do think the surgery is worth it for anyone with a severe VL.

I really do wonder why they stopped posting. I remember when I had 3 years of being happy with Cialis and its effects I just forgot I had a leak as everything was easy. Now that doubt has crept into my mind with the fear its effects will one day wane, I'm back on the board.

I hope that they are near enough fixed and therefore wanted to put all of this behind them. It's either that or they had very disappointing outcomes in the long term.

I'm praying the former is true!

Razor, Oxford, talk to us!

[PFracture]

I don't want to criticize them, but i think that when people don't post anymore i always think that it isn't for a good reason.

[merrix]

If I remember right, both of them already described a retrogression to a pill-depending hit and miss status. Basically like the results I got. Improvement bu no cure.
So for all you guys here thinking of the sclero: I think it is fair to say that nobody (yes nobody) here on FT got cured.

On the other hand, looking at myself and the route I took, if my implant surgery would not have been such a success (from a surgical technical standpoint) as it was, I think I would have rather stayed with an improved ED. Having an implant which doesn't work very well must be double the hell in my opinion.

So no advice from my side. Just think carefully, judge your options, and set your expectations right once you decided what to do.