Venous leak

Venous Leak, also called Venogenic Erectile Dysfunction and Penile Venous Insufficiency, is a cause of Erectile Dysfunction in males,^[1] often inflicting young men, unlike other organic causes of Erectile Dysfunction. Much about the venous leaks is still unknown and many aspects of the condition is highly controversial among the medical community. Medical Professionals likely to come across Venous Leaks are General Practitioners, Urologists, Andrologists, Psychiatrists, Endocrinologists and Radiologists. The prevalence of the condition is still very much unknown, although some sources claim it to be a common cause of Erectile Dysfunction.

Signs and symptoms

Most men suffering from Venogenic Erectile Dysfunction start having trouble with their erections from a young age. Common complaints include; A chronic soft erection insufficient for sexual intercourse, position-dependent erectile rigidity, difficulty achieving erections, difficulty maintaining erections without constant manual stimulation and a soft glans of the penis during erection.

Physicians often look for signs that suggest an organic cause of erectile dysfunction rather than a psycho-osmotic cause, in making a diagnosis of Venous Leak. Such suggestive signs include; (1) Erectile Dysfunction that is persistent on all occasions where an erection is required including with a partner and without a partner during masturbation. (2) Loss of quality of Morning Erections (3) Loss of quality of spontaneous erections and multi-treatment resistance to traditional Erectile Dysfunction medications including Sildenafil and Cavernosal Injection Therapy.

Causes

Venous Leak is an inability to maintain an erection in the presence of sufficient arterial blood flow through the cavernosal arteries of the artery. The defect lies in the drainage of the cavernosal tissue of the penis, which under normal function provides high resistance to venous blood flow from the penis during an erection, thus keeping blood 'trapped' inside the spongy chambers of the penis, to maintain an erection of adequate strength for an adequate length of time. It is still disputed as to what causes the excessive 'leakiness' characteristic of the condition, however it is mostly thought that the defect is in the connective tissue of the tunica albuginea surrounding the penile veins, most importantly the Deep Dorsal Vein of the penis. Histological specimens of cavernosal tissue in patients with confirmed veno-occlusive disorder show changes in the structure of collagen and elastin making up the connective tissue of the penis, when compared to a control group. These changes may be responsible for such symtptoms.

Other possible causes; - Trauma - Testosterone Deficiency - Prostate Resection Surgery

References

1. Rogers RS, et al. (Feb 2003). "Intracavernosal vascular endothelial growth factor (VEGF) injection and adeno-associated virus-mediated VEGF gene therapy prevent and reverse venogenic erectile dysfunction in rats.". Int J Impot Res. 15 (1): 26–37. doi:10.1038/sj.ijir.3900943. PMID 12605238.