Penile Doppler Ultrasound revealed Venous Leakage

Basically revealed that blood flow into my penis is fine, but blood does not stay in, and escapes out. I didn’t want to debate the cause of this or existence of PFS with him, but in my limited research I believe it to be due to androgen silencing.

Anyways, he prescribed me BiMix to inject into penis. Same thing he injected me with to stimulate an erection for the doppler today. In 10 minutes it made me 90% erect but only lasted a few minutes. Similar reaction I have to Alprostadil/PGE1/Caverject, except no pain with BiMix.

I’ve done a lot of research on penile implants over the past few months and it seems like the route I will go. He said he does 50-60 a year and at my age is not a huge fan of the idea but gets why I want to and is willing to.

Did he not suggest you try rings or something similar first?

I have a ring, I can try it but it still requires injections or pills. I’d rather just pump a few times and go.

I am sorry about that, moonman. Hope you can find a solution to it.

@axolotl and @awor are collecting penile doppler scans for a paper they are writing. If you can send yours to them, given the fact that yours revealed that you have venous leakage, it would be an important evidence. I sent mine to axolotl with my name erased.


sorry to hear moonman this really has increased my anxiety reading this. Im in my 9th year of dealing with pfs symptoms from taking saw palmetto & was really rooting for you. trying to figure out my erection quality & flaccid size atm

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I think I’ll have to get one myself soon. Considering the extremely slow pace whatever little research is made goes, a treatment seems virtually impossible to me, at least in my lifetime (I’m 37).

It’s emotionally devastating to turn down women who are interested in me because I’m unable to have sex. I try to focus on other things and not think about it, but sometimes it’s unavoidable and I feel like I’m slowly approaching a point where I won’t be able to take it anymore.


May be try TRT First ?

In this study we investigated whether long‐acting testosterone therapy restores erectile function in hypogonadal patients with venous leakage. We employed DDU, PCG, and MRI as tools to determine venous leakage before and after testosterone therapy. Our findings suggest that testosterone therapy improved erectile function in hypogonadal patients with venous leakage. This study confirms and extends the observations previously reported by Yassin et al (2006), demonstrating that testosterone restored erectile function in some patients with veno‐occlusive dysfunction.

In group 1 patients treated with the long‐acting testosterone, the level of plasma total testosterone increased to those levels found in normal men after 18 (18 ± 0.25 nmol/L [518 ng/dL]) and 30 weeks (21.5 ± 2.3 nmol/L [620 ng/dL]) of therapy. Similar data were shown in group 2 (Table 4). Overall, the total testosterone remained within the normal limits of physiological levels.
Testosterone treatment significantly improved erectile function after 18 and 30 weeks of therapy. Seventeen out of 20 patients from group 1 and 7 out of 9 from group 2 reported satisfactory sexual activity after testosterone treatment alone. After testosterone therapy, we repeated DDU in 17 patients with documented venous leakage. Assessment of penile hemodynamics (erectile function) with DDU suggested reduced or absent venous leakage.

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I’ve tried TRT in many different formats. I’ve tried multiple androgens and none of them do a thing. I’ve had T levels as low as 99 (lower than most women) and as high as 1,200. Overall I’ve spent close to $15,000 on just HRT.

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I am so sorry my friend it seems only option is surgery. Did you stay on Trt more than 30 weeks ? Please let us know how your surgery went I hope you can fix and end this nightmare.


Estrogen in animal models impedes normal penile development, including reduced bulk of the bulbospongiosus muscle, reduction of the spaces in corpus cavernosum, and an accumulation of fat cells within existing spaces that lead to ED in adult life. Notably, the reported exposure was limited to early development, and rats that were exposed to exogenous estradiol after day 12 of life showed no structural abnormalities. [39] In addition to influence on structure, estrogen has a significant influence on penile vasculature. A case-control study of male outpatients with ED with venous leakage showed that the only difference between the men with and without ED was an increased estradiol level. The authors concluded that estradiol increases venous vascular permeability via VEGF and has a detrimental effect on erectile function through increased venous leakage. [40]

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Please update your results if you do a dopller scan. Im curious, everyone who has pfs should do this test. Im trying to get one too.