Venous Leakage. Is there any hope?

Hi there
I’ve been to the doctor recently and I was told that I had venous leakage based on my ultrasound. I was also told that there is no way to reverse this except surgery, which has mixed results.
I guess at this point there is no hope that my sexual functioning will ever return to normal. Are there any cases that had confirmed venous leakage and recovered?

I also have this condition, firstly, i believe it will improve with time, penis pump is benefiting, also daily cialis, and regular training. I’m currently starting tribulus, i will update.

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I also was diagnosed with it.

I did some research and it appears its most likely a result of our AR’s being silenced. If we are able to reverse that silencing, then we should be able to fix the VL


Yeah, it says that people with low t or diabetes can have that and that it reverses when the problem is addressed. In our case it probably has to do with the receptors

venous leak is a very dangerous and misleading term which is used by urologists to explain ppl cant maintain an erection

Most of the time there isn’t an actual leak or some kind of hole in your veins (which is why surgery doesn’t work) but your penile smooth tissue is not relaxing sufficiently enough to trap your blood in the penis. Smooth tissue relaxation is caused by nitrous oxide, which is regulated by neurosteroids, which are regulated by your androgen levels ie what finasteride has screwed up. If you increase nitrous oxide in your system, through cialis or arginine for example…i would suspect your “leak” goes away. If it was a venous issue this wouldn’t be the case

I know this because ive been through the same experience and thought my life was over

Went to get a second opinion / second doppler while on daily cialis and a world renowned endo said by penile structure was fine and everything was perfect

Got a third opinion / third doppler by another expert endo (while not on daily c) and couldn’t get an erection after caverject… despite this guy said there was nothing wrong with my penile structure

this isn’t the death sentence for your sexual
health and will likely improve over time as your androgens normalise. Use cialis in meantime

Disclaimer im not an expert


I think you meant nitric oxide, because nitrous oxide is a drug.
Arent neurosteroids influencing libido, sleep and other cognitive functions? Can you explain how they influence erectile quality directly or indirectly?
It’s interesting that you didn’t have venous leakage while on cialis since all urologists say that pde5 inhibitors don’t help with venous insufficiency, only with inflow. I guess there is some merit to the relaxation of smooth tissues as you described.
Thanks for your input

ha correct as I said clearly not an expert!

If you read the melcangi papers he discusses how neurosteroid issues explain the plethora of symtoms we experience

cialis works by relaxing your smooth muscle tissues therefore enhancing erections…mine dont relax enough but im usually 100pc after cialis. Ive also had periods where Im 100pc without cialis…so its definitely not some permanent structural problem, id bet you are the same

from my reading and discussions, venous leakage is a lazy catch all diagnosis to describe a person who cant maintain an erection…there are multiple reasons as to why this might be the case


Shockwave Therapy…Check my thread…

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actually tried that myself as well…twice…cost me 6k

def did something but not a silver bullett


Planning to try it if nothing else works

Anything to report on it?

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helped a bit i think, size particularly

but no magical cure

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Fyi, there was someone here who said you could buy your own machine for less than a couple of sessions.

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As eskimojoe said I doubt you have “real” venous leakage. The problem is that your penile smooth tissue is not relaxing sufficiently enough to trap your blood in the penis. Some hypygonadal men can benefit from TRT (Testosterone Replacement Therapy)

but our case is more complex. I really believe this is an androgen problem.

I have had two doppler tests. First time I couldn´t get the erection even with the Caverject injection. The radiologist who did the doppler test was so baffled that he eventually gave me two injections. But nothing happened. He couldn´t tell me what was going on… The urologist who then looked the results told me that I couldn´t have venous leakage because he has seen only one venous leakage case in his whole 30 year career and it was caused by the operation to resolve priapism.

Second time I went to the most respected doctor in my country Juhana Piha (he is known in Europe also). He did really extensive doppler test. This time I actually had few minutes erection (this test was made about 6 months after the first test and during this 6 months waiting I had tried Vigra, Cialis and Vitaros). He told me that my blood flow was really good, veins were in excellent condition and there was no abnormal in penile structure. So NO VENOUS LEAKAGE! He also told me that he has seen similar cases before caused by antideprassants and Finansteride… and this condition is called PSSD… and there is nothing else he can offer me than TRT…

I didn´t start the TRT, but waited… after about a year I started to have nocturnal erections. First they were weak and random. Then I found this study

and started taking Pycnogenol and L-arginine. My nocturnal erections got strong and regular. The problem was that it was still hard to maintain erection while standing(?!). But at my best I could have erection while standing and keep it up about few minutes without touching. So if I had taken also Cialis I probably could have had erection good enough to have sex. But I try not to take any “medicines” for now. So now I have stopped taking Pycnogenol and L-arginine and I still have pretty good nocturnal erections, but erections while standing are not possible. My next plan is to fix androgen problem and combine then Pycnogenol and L-Arginine to that regimen. Hope that will work.

So what I want to say to you, THERE IS HOPE!!! I was total impotent (no erections with Viagra, Cialis, Vitaros on even with the Caverject injections) but now I have regular nocturnal erections. It still Something and proves that nothing is completely broken. Stay strong!


I also can’t maintain my erection when standing. When I’m lying or sitting it seems to be a lot easier. Interesting why this happens.
Appreciate the lengthy response!