Erectile Dysfunction: Causes, Symptoms, and Treatment Options

Q: Erectile Dysfunction: Causes, Symptoms, and Treatment Options

For those who are concerned： First, it is essential to confirm the diagnosis. <br>You can go to a hospital for a penile venous leak test to determine if there is a leak and assess its severity, including how many veins are leaking. <br>Additionally, an erection hardness test can

Erectile dysfunction

Hello Doctor: Recently, when I have intimate relations with my wife, I feel that the hardness of my erection is not as good as before, and it easily becomes soft.
Without stimulation, my penis becomes flaccid within twenty seconds.
If I change positions or remain still inside the vagina for a few seconds, I can feel my penis softening.
A doctor mentioned that an erection should be able to be maintained for a few minutes without stimulation, but for me, it only lasts a few seconds.
Comparing the information I found online with my own situation, I suspect that I might have a venous leak issue.
However, sometimes when I wake up at night, I notice that my penis is quite engorged, and the erection can last for about half an hour.
According to the information I found online, a venous leak means that the penis cannot retain blood within the corpora cavernosa.
Does this imply that whether the erection is due to sexual stimulation or because of a full bladder at night, the duration of the erection would not differ significantly? If it is indeed a venous leak, I would like to know which hospitals perform this surgery and what the approximate costs are.
Thank you!

Fanrao de ren, 20~29 year old female. Ask Date: 2010/03/29

Dr. Xu Weikai reply Urology

For those who are concerned: First, it is essential to confirm the diagnosis.
You can go to a hospital for a penile venous leak test to determine if there is a leak and assess its severity, including how many veins are leaking.
Additionally, an erection hardness test can be performed as part of the preoperative evaluation.
Generally, venous leaks tend to persist, and it is rare to experience intermittent erectile function.
Most of the time, this situation arises from insufficient stimulation leading to poor erection hardness, rather than being solely due to venous factors.
You can call the urology department of the hospital to inquire about the surgery, which typically requires out-of-pocket payment.
As for the costs, they vary from hospital to hospital, depending on the surgical method and the hospital's policies.

Reply Date: 2010/03/29

More Info

Erectile dysfunction (ED) is a common condition that affects many men at various stages of life. It is characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Your description of experiencing a decrease in erection hardness and the rapid loss of rigidity during sexual activity raises important considerations regarding potential underlying causes and treatment options.

Causes of Erectile Dysfunction
ED can be caused by a variety of factors, which can be broadly categorized into physical and psychological causes:
1. Physical Causes:
- Vascular Issues: Conditions such as atherosclerosis (hardening of the arteries) can restrict blood flow to the penis, making it difficult to achieve an erection. Venous leakage, or "venous leak," occurs when blood flows into the penis but leaks out too quickly, preventing a firm erection.

- Hormonal Imbalances: Low testosterone levels can affect libido and erectile function.

- Neurological Conditions: Disorders such as multiple sclerosis or Parkinson's disease can interfere with nerve signals from the brain to the penis.

- Chronic Conditions: Diabetes, high blood pressure, and obesity can contribute to ED by affecting blood vessels and nerve function.

2. Psychological Causes:
- Anxiety and Stress: Performance anxiety or stress related to personal or professional life can impact sexual performance.

- Depression: Mental health issues can significantly affect libido and erectile function.

- Relationship Issues: Problems with a partner can lead to anxiety and affect sexual performance.

Symptoms of Erectile Dysfunction
The primary symptom of ED is the inability to achieve or maintain an erection. Other symptoms may include reduced sexual desire or libido. It is important to note that experiencing occasional difficulties with erections is normal and does not necessarily indicate a medical condition. However, if these difficulties persist, it may be time to seek medical advice.

Treatment Options
1. Lifestyle Changes: Improving overall health can have a positive impact on erectile function. This includes:
- Regular exercise
- A healthy diet
- Quitting smoking
- Reducing alcohol consumption
- Managing stress
2. Medications: Oral medications such as phosphodiesterase type 5 (PDE5) inhibitors (e.g., Viagra, Cialis) are commonly prescribed to help achieve an erection by increasing blood flow to the penis.

3. Therapy: If psychological factors are contributing to ED, counseling or therapy can be beneficial. This may involve individual therapy or couples therapy to address relationship issues.

4. Vacuum Erection Devices: These devices create a vacuum around the penis, drawing blood into it and helping to achieve an erection.

5. Surgery: In cases of severe ED due to anatomical issues, surgical options may be considered. This includes penile implants or vascular surgery to improve blood flow.

Venous Leak and Surgical Options
You mentioned concerns about venous leak, which can indeed affect the ability to maintain an erection. Diagnosis typically involves a physical examination and possibly imaging studies to assess blood flow. If a venous leak is confirmed, surgical options may include procedures to ligate the veins that are causing the leak, thereby retaining blood in the penis during an erection.

Conclusion
It is essential to consult with a healthcare provider specializing in urology or sexual medicine to discuss your symptoms in detail and undergo appropriate evaluations. They can provide tailored advice and treatment options based on your specific condition. Remember, addressing ED is not just about physical health; it often involves psychological and relational aspects as well. Seeking help is a positive step towards improving your sexual health and overall well-being.

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