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QUESTION: Hello sir I want little information from you regarding my problem .
I also wanted to increase my sexual knowledge.
My question is what is exactly venous leak ?
Sometimes man is not able to maintain erections and loose rapidly so that mean he is suffering from venous leak ?
And what is other conditions that exactly equal to venous leak but not venous leak ? I mean what is other causes of rapid loss of erection other than venous leak ?

Now I am coming to my problem .
I had little limp on base of penis at the time of ejaculation so doctor
Told me to that I have penile thrombosis and need to do Doppler ultrasound I did it and result was unexpected report suspected probability of venous leak . after that I went for second opinion , other doctor told me that you were misguided by first doctor . he told me I don't have venous leak . he also told me that because of anxiety of paparvine injection you loose erection and report misdiagnosised .
Doctor who performed DUS was not so experienced .
Because of anxiety of venous leak . doctor suggested to performe DICC cavernosometry . and test was normal and suggested no venous leak. From that day due to anxiety of venous leak and performance anxiety so I am loosing erections rapidly.
I AM ALSO SUFFERING FROM OCD , DEPRESSION , STRESS , ANXIETY , PANIC ATTACKS FROM last 5 years I AM JUST 23 YEAR OLD boy .

My psychologist told me your anxiety directly effects erections .
I also did two more ultrasound with vigra .
Both come normal and not able to find anxiety .but now I am not able to maintain erection .
I can maintain it while masterbration so but when I stop masterbrating I loose erection.
I can maintain erections during penetration .
And foreplay but if my mind divert from sex I loose erections rapidly . if I feel anxious and depressed I am not able to maintain erections .
I am also not able to maintain sexual arousal . and not able to concentrate on sex .
Anxiety of venous leak killing me .

Please help me sir what should I do ?
I don't have knowledge what exactly venous leak is and am I really have it or not.
?
But I have lot of fear of venous leak because of wrong diagnosis of venous leak .
I had 10 time sex after test 8 time I performed well .
But whenever I feel doubt of venous leak .
I loose erection rapidly .

Currently I am taking flunil 10mg daily .
I can maintain erection with cialis .

Help me sir how to erase my daubt of venous leak permanently ?

ANSWER: Bunny:

Venous leak means that there is an obligatory loss of erection rigidity immediately after reaching maximum hardness.  It is due to an insufficiency in the venous control system of the penis.  Your description does not meet this definition as your dysfunction is more situational which suggests its due to your anxiety related issues.  In other words, it's possible for your anxiety about venous leak to cause you lose the erections even though you don't have venous leak.

If Viagra type medications are not working, then a different treatment should be tried such as penile injections or an external vacuum system that provides a very reliable form of rigidity that is useful in anxiety or emotional related ED.  Good luck.

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

QUESTION: Thank u sir.for answer
Sir what is poor smooth muscle relaxation ?
I read somewhere on net that poor smooth relaxation also cause this problem.

What is relationship between poor smooth muscle relaxation and venous leak ?
I also read that anxiety effects neurotransmitter . and give signale to penis and because of anxiety , blood inflow reduce and output flow increase ?
How to fight with problems ?

ANSWER: Bunny:

There is way too much anxiety in teh general publich about venous leak.  This is only one type of problem that can cause ED.

The main tissue inside the erection bodies is smooth muscle tissue, similar to the muscles in the eyelid, sphincters and intestines.  Smooth muscle tissue can hold things for a long period of time, just like the anal sphincter.  When smooth muscle inside the erection bodies relax, blood flow dramatically increases.  When this is sufficient, the erections can then occur.  If they are unable to relax, then an erection is less likely or may even be impossible.  Viagra and similar medications work to cause smooth muscle relaxation; in fact, that's how they work!

There is no relationship between poor smooth muscle relaxationand venous leak; they are separate entities.

Anxiety can definitely affect neurotransmitters and erection function resulting in lower peak arterial inflow.  Dealing with these problems means getting better control of anxiety if excessive and using some type of treatment that facilitates full or at least adequate erectile function such as an External Vacuum Device.

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

QUESTION: Hi sir thanks for reply.

I can maintain erection with low dosage of vigra and cialis .
But how many  time I have to take it ?
This will become habit ?

And currently I am taking flunil 20 mg tablet for mental problem.
I can maintain erection also because I am less anxious but.I my libido is decrease.

And when I stop taking flunil my erection functions fall down because of anxiety.

Please help me sir what is best sexual and mental medicine for me for maintain balance both ?

Answer
Bunny:

You will need to take viagra or cialis every time you wish to use sexual function.  It doesn't really become a habit any more than taking tylenol for a headache or eating a sandwich when you're hungry is a "habit".  Until or unless your problem is resolved or fixed, you have the choice of using a medication to help or doing without.  Your choice.

Deciding which is the best medicine in your particular case will depend on the details of your situation.  In other words, you'll have to talk to your local personal physicians.   Good luck.  

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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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