PIED or venous leak?

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goldpeak93

Member
Just found this article online- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746402/

Found this specific part interesting- "As maximal penile rigidity is achieved in the final phase, the IP is equal to or greater than systolic, producing further narrowing of the systolic peak. In some cases the systolic velocity may reduce to such an extent that there is a transient interruption to systolic flow".

As noted in the dictation from the doc, there was a "transient decrease" in the one of the arteries near the conclusion of the test. I'll hopefully get clarification on this tomorrow, but it doesn't sound that abnormal concerning it is documented in the study.
 
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ojacek

Member
Sounds about right.

I think that is similar to what my uro told me but in more comprehensive way :)

Anyway I bet that Doctors hate when patients come up with knowledge from the internet trying to undermine theirs gained over the years of learning in medical environment. Mine seemed irritated when I called him up about it :). But my sanity was more important then Doctor's temporary exasperation.

Stop reading this stuff, you re going to drive yourself nuts. It won't give you any comfort in the long run. And if tomorrow you get yourself assured that you're fine please try to believe them and if not schedule another test if you feel they have performed it wrong. I had to ask few doctors around to actually get myself convinced, and read entire internet about it. Paid fortune for all those consultations, appointments, tests etc.
 
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goldpeak93

Member
Well, got the CD with my doppler results today. After extensive review and figuring out how to read it myself, I finally believe the doc when he says my results were "normal." Some of my results looked questionable/borderline, but I'm guessing my nerves and injection of 1/4 of the medication didn't allow for a full blown erection. I'm not sure if I should get retested or not, but I'm guessing my results would be better since my erection quality has improved a little (w/o use of medication) since I got the test done.

Really hoping this is just a bad case of PIED. Found a study saying the doppler isn't completely conclusive for diagnosis of venous leak, but I think these results look somewhat promising.
 
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ojacek

Member
To be honest i think PIED is only part of your issues, you have also strong anxiety problems, which worsens your condition, and I am speaking from experience. Also it is normal to loose erection fast after you've induced it by your own hand. Yesterday my 20 seconds erection problem existed, today I spent some time with my GF and as long as I wasn't focusing on my erections quality, they seemed to maintain themselves way longer, and all this after I've changed my thinking. Mind and subconcious is really powerfull. 
 
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UselessMeat

Active Member
We've all thought we've had venous leak at some point... it's EXTREMELY unlikely that it's a venous leak. Before I quit watching porn and rebooted my cock would do exactly what you're describing. It works as it should now whenever I need it to for sex. I don't wake up every night with a 100% rock hard boner (but this does happen). I highly suggest you reboot.
 
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goldpeak93

Member
Thanks for the responses. They definitely put my mind at ease.

Stopped masturbation for a week but cracked yesterday. My cock was rock hard with glans/foreskin stimulation, but went away seconds after stimulation stopped. I'm not able to stay rock hard with normal jerking off motion (I think due to decreased shaft sensitivity).

Couple things I noticed about my erection..
-I noticed the bottom of my penis (corpus spongiosum) has a squishy feel to it when erect, while the corpus          cavernosa are both rock hard. Is this normal?
-When erect, I need to kegel to stay hard. Before my issues started, I would usually keep a kegel when erect because it felt better. PT said my pelvic floor muscles were overactive, so she helped me loosen them up. Now, after 10-15 seconds of kegeling, the muscles seem to weaken, resulting in loss of erection. Any advice for this?
-Does my ED really seem like something that can be remedied? I've had issues since last January. My EQ has definitely increased and some sensitivity has returned, but a year seems like a really long time to have these issues.

Any advice appreciated, thanks!
 
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ojacek

Member
Have you double checked you blood work?

Question 1 : The shaft is supposed to be hard and it's normal
Question 2: Start normal kegels and reverse kegels, I've noticed improvement after reverse kegeling more often. Your pelvic floor can be both tight and loose, so it needs some sort of a balance
Question 3: It could be remedied but you need to keep on going with reboot, and give it more time, I've managed to gain 10-15 sec more after cutting all porn, and was always "ready" after just kissing.

I've changed my stance a little about psychological issues really.
I used to have very similar problem to yours, and I stopped porn for many months but I still needed manual stimulation to maintain a boner, but had some 10-15 seconds more than you.

I was taking some supplements etc. and I was adviced to buy drug containing DHEA hormone, and after a 1,5 month - regular morning erections back (had only nocturnal), had more than a few situations when I could walk around the house with dick out and it wouldn't go down for several minutes. Did not require constant manual stimulation etc.

But I thought it was natural me, and my mindset changed - thus improvement. I did not connect the dots that hormones supplementation is actually helping me big time. I double checked my blood results and sexual hormones, all were within ranges but all of them were close to bottom of it's range, or when needed lower close to the top. So urologist were saying if it is within ranges then it's fine.
Went to endocrynologist/angiologist and he just confirmed that I have some sort of hormonal imbalance. FUCK!

Good news:
- I know that DHEA is working really well.
- My girlfriend seems to accept it and she's "with me on this".
- It can possibly be controlled via medication
- I just woke up with morning wood, and walked around the house with it - again
- No venous leak

Bad news.
- I could be going for years trying to find perfect hormones supplementation to make things right
- Maybe I will have to wolf down hormonal drugs for the rest of my life..
- Do I still have PIED which makes things even worse?
 
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goldpeak93

Member
Ojacek- I've only had one blood test (back in March), and doc told me everything was "normal." Testosterone was 359. That seems pretty low for a 23 year old healthy, fit guy. I'm going to request another test to see if those values have changed at all.

I've refrained from any PMO for the past full week. A couple days ago, I woke up with 70% morning wood, so that made my day, haha. I've been really busy lately, so I've been able to get my ED issues out of my head. Last night, I was on a Netflix binge and my dick was completely out of my mind. Popped a 60% erection which lasted for a good 6 or 7 minutes. I then started to get some sexual thoughts which made it go up a little more, but I got those out of my head ASAP and lost my wood.

I'm still wary about this whole situation since it's been going on for a year already, but these seem to be good signs. I'm doing my hardest to beat this. I will look into the DHEA, thanks for the recommendation!

I'm going to ask to see an endocrinologist at my next appointment. I'm determined to get my hard as steel wood back, lol.
 
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scorpion1386

Well-Known Member
goldpeak93 said:
Ojacek- I've only had one blood test (back in March), and doc told me everything was "normal." Testosterone was 359. That seems pretty low for a 23 year old healthy, fit guy. I'm going to request another test to see if those values have changed at all.

I've refrained from any PMO for the past full week. A couple days ago, I woke up with 70% morning wood, so that made my day, haha. I've been really busy lately, so I've been able to get my ED issues out of my head. Last night, I was on a Netflix binge and my dick was completely out of my mind. Popped a 60% erection which lasted for a good 6 or 7 minutes. I then started to get some sexual thoughts which made it go up a little more, but I got those out of my head ASAP and lost my wood.

I'm still wary about this whole situation since it's been going on for a year already, but these seem to be good signs. I'm doing my hardest to beat this. I will look into the DHEA, thanks for the recommendation!

I'm going to ask to see an endocrinologist at my next appointment. I'm determined to get my hard as steel wood back, lol.
Click to expand...

What's a normal testosterone reading for a 30 year old? My testosterone results came back normal as well.
 
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goldpeak93

Member
I think "normal" T levels just depend on how your doctor defines it. I know that after your 20's, it is normal for T levels to start dropping. Most sites I've found online say that 300-400 is relatively low, especially for a guy my age. My doc says anything above 200 is normal, which I find to be BS. I'm not sure what normal T levels for a 30 year old guy are unfortunately. I don't believe there's a universal norm for normal T levels.
 
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ojacek

Member
Yeah my endo told me that at my age I should be around 700-800 :). Some guys struggle below 400-500(and others feel just fine)! He also told me that the ranges varies from lower scale to the top like 200-300%. So references don't matter that much, it is what works for you. I think 300-something is low to be honest and worth looking into, I was close to 400. Check also LH, FSH, SHBG, estradiol and free T, those matter a lot.

But plenty of doctors say that if it is within ranges then your normal. It is all in your head - but then again I just had too much evidence that it is not, after DHEA and dramatic improvement that went with it. Try to find some endo specializing with man's problems endo-angiologist, cause others are gonna say that you're fine, because you're "within normal ranges" even though it is evidently low.

Also it is not only about T. It can be Estrogen/T ratio, high or low estradiol, or like for me high SHBG that "eats away" free testosterone available and after some time ... problems.
 
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goldpeak93

Member
Well.. Had a follow-up appointment with the urologist who ordered my ultrasound. I brought up my fear of a venous leak, and he said he is 100% sure that I do not have it. He also said there were no signs of plaquing, so Peyronie's is very unlikely. In the end, he said my issues all seem to be psychogenic.

That being said, he offered me a referral to Mayo Clinic. Since this issue has persisted for so long, I acted on the offer and set up an appointment for the end of the month.

In the meantime, I am 3 days into nofap. I keep getting random, small erections throughout the day, so I'm thinking that's a good sign (?). I've been consistently exercising (cardio and lifting) the past couple days, so I'm hoping this will have some effect. My only issue.. my libido shoots through the roof for a half hour or so past my workout. I'm finding it really difficult to keep sexual thoughts out of my mind during this time, but I'm trying my hardest for success.

One thing I guess I'd like some reassurance on.. A majority of the PIED info I find online says that you should be able to get erect (and supposedly stay erect) with porn if that is the root cause of your ED. No matter what porn I watch, I literally need constant stimulation to keep it up. I know I definitely have a porn addiction considering the fact that I'm only 3 days into my reboot and I'm going crazy not looking at porn. But the way my dick is acting seems really bizarre. Thoughts?
 
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ojacek

Member
Dude, you just dwell on negatives too much. What I don't understand is your porn consumption. I guess if I had such issues for so long I wouldn't watch any porn anymore.
Have you looked into T levels again, you said you were in 300's? Seems real low to me. I am on medication-boosting my T right now and the improvement is IMMENSE.
 
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Samuel King

Member
Your T levels do seem quite low in my opinion for your age. I am 35 and mine is at 515. Which even to me feels low too. So I am working on naturally boosting T through diet, fitness, sleep and nutrition since these can all boost T if done right.

T references are difference each time and each doc will probably use different references. Your T probably wouldn't hurt from getting a boost. But do it naturally, not using anything weird like "T supplements" or even medical grade stuff. Try natural route first.

Check out this article by AoM on Testosterone. http://www.artofmanliness.com/2013/01/16/normal-testosterone-levels/

I think "normal" just means you are "within the range" of not being an issue over all. However I think considering your age and your lifestyle is how you should judge your T levels. At your age I reckon you should be at least in the 500+ range if not higher.

But I do think most people with ED experiences are OVER WORRYING and OVER ANALYZING including myself, and I think it is making the problem much more of an issue.

I have High Cholesterol which I am working on reducing, but I was sure it could be the cause of my ED issues. I asked my Doc about it and he said, "nahhh you don't seem to fit the bill for someone that could have ED issues because of HC." And I'm like ??? really? Cause everywhere I read it COULD BE LOL.
 
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goldpeak93

Member
Update I guess.. Saw the head andrologist at Mayo Clinic at the end of February. He ordered another ultrasound with which I received similar results to the first one: no sign of venous leak/other abnormality. At Mayo, I consulted with the ED specialist and 2 of his partners, all concluding that there was nothing physically wrong with my penis. He thinks my ED is the result of a hyperactive nervous system, which shuts my erectile response down as soon as it begins. To help counter this, he put me on 20 mg daily viagra. I've been taking this for a little over a month, and I'm not really sure if it's helping or not. He instructed me to take it right before bed. I wake up in the middle of the night with 60% wood and sometimes wake up with similar morning wood. I am still unable to maintain an erection with masturbation though.

When the specialist went over my doppler results, I expressed my concern about the validity of the assessment. He claims that the doppler is highly accurate and would've been able to detect a leak. Looking online though, I see that the doppler is unable to detect the superficial dorsal vein which is the cause of a leak in some situations. He has no doubt that my situation will get better with time. While I want to believe him, I still have my doubts due to stuff I've read online. Mayo Clinic is the #1 urology provider in the nation, so I'm sure they would've been able to find anything if anything was truly wrong. Any advice?? Thanks!
 
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Dfletch07

Member
Understand PIED vs venous leakage from this perspective too and again the root of the issue to it, refer back to YBOP.com. I apologize that I haven't sifted through all the comments either.

As long as we maintain a high enough stimulus through masturbation, the brain helps us maintain that erection. The problem is we force our brain to correlate both the visual stimulus (porn) and the stroking sensation (our hand) to only send a neurological impulse to "maintain an erection for sex." This is the basic reason we find real sex boring... same nude woman and it doesn't feel like our hand when there is intercourse or other measures done to the penis. Once we cut away either PMO stimulus the brain is no longer turned on and shuts the system down immediately. It is also a well-oiled system, because lets face it... you use it frequently. It has a quick on off switch and reaction base because of it.

I struggle even with standing erections and they go away even quicker because of my "habitual masturbation." A lot of this is because of PMO positioning, commonly laying down), and a constant stroking pattern to what I was watching.

Bottom line is that most individuals do not have venous leakage issue in the early part of their life unless there was so form of trauma. My thoughts and research on things plus a medical background to support

-DF
 
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