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QUESTION: Hello sir
In July 2014 i had pain on penis.so urologist told me to do penile dppler
I did result was totally unexpected . possibility of venous leak.12 to 18 cm sec EDV
I dont had ED problems i was able to maintain erection before but
After test till now i am not able to maintain erection even for secend .
I was anxious during doppler specially abt injection . doctor told me you
May not have venous leak this only vecause of anxiety. Doctor told me to
Do DICC cavernosometry test report was normal.and no.venous leakage
Is seen there . in dec 2014 i did penile doppler again with 100 mg viagra
And report was normal this time.EDV was 0 and reverse flow was seen.
I am still not able to maintain erection more than 10 sec..
I am confused which report is right
Doctor gave me 5 mg tadalafil .
I can maintain erection till 30 min
What is other cause then venous leak that i am not able to maintaine
Erecction ..??
What is definative test of venous leak
?
I really have it???
Or because of anxiety ???
I am 22 only and i am also suffering from OCD depression anxiety and  hypochondria
From last 2 years
Please help me anxiety of venous leak killing me every day

ANSWER: Pratik:

The overwhelming likelihood is that you do not have venous leak and this is due to anxiety.  It is not considered necessary to do any "definitive" testing for venous leak since it doesn't affect treatment.  However, the "definitive" test for venous leak is the DICC and you've had it with normal findings so the obvious conclusion is no venous leak.

You said it yourself: your anxiety about venous leak is hurting you; so the real problem is your anxiety about it.  Clearly the tadalafil is working well for you, so you need to concentrate on dealing with the anxiety issues.  Talk to your mental health professional about this aspect of your health.

---------- FOLLOW-UP ----------

QUESTION: Thaks a lot sir 100% feel free ..
But 1 st penile Doppler test is one of horrible experience for me
If i don't have venous leak then why they gave me report of possibilities of venous leak ???
I cried i alot that day . i dont have any addiction of smocking drinking why i have venou leak
Doctor sau if you want reduce anxiety ,do dicc test i did my city 's top urologist did
My cavernosometry ,doctor told me You dont have venous leak at all. The person who did your penile doppler mau not have expreince of penile doppler so he gave i wrong report .
I did 2 penile doppler again both came normal.
But cannot able to forget 1 st wrong report . this become anxiety for me whenever i remeber i feel painc
And exactly happening With me , like venous leak.
I got erection but it loose in few seconds , i never experience such ED before 1 st penile doppler
All this started happaning from  1 st Doppler.

Whatever it is sad story of mine just coincidence . unfortunately i am suffering from anxiety and OCD desorrder
That Doppler report made me more amd more anxious .. From last 6 month i masterbrated 60% checking myself and 40 % for pleasure..
Because of that Doppler report i loose my sexual confidence. I hope u can understand my mental situation.

But whatever that was past

I 100 % believe on your advice . if u told.me i dont have venous leak than then yess i don't have that .

Please sir help me to solve my problem and please tell me what possible cause now
Other than venous leak that i am not able to maintain erections ??
What is general causes that man not able to maintain erection and loose erections in few second (other than leak )???
Please suggest me good medicine for maintaining erection.

How should i increase my sexual confidence which i loose because of above incident??
I am loosing erection quickly because of mental disease ???
Please help sir and thanks alooooooot sir for reducin my anxiety ..
( i send my doppler report picture to u )
Please forgive me if I wrote something stupid .

Answer
Pratik:

There are lots of potential causes of ED included vascular disease, arteriosclerosis, diabetes, hypertension, neuropathy, hormonal issues, radiation, pelvic trauma, surgery, back and/or nerve problems, endothelial cell dysfunction, etc...

Since the DICC was negative, the most likely causes in your situation would be anxiety related.

Treatments for ED include oral medications like tadafil, urethral suppositories (MUSE), external vacuum devices and penile injections.  You can talk to your urologist about which ones might suit you.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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