What is a Venous Leak, and How is it Treated?

One of the more common causes of erectile dysfunction is a condition called a venous leak, also known as venogenic erectile dysfunction.

When a man has a venous leak, all of the mechanisms that produce an erection may be working normally. The man becomes aroused. Chemicals and nerve impulses carry signals through the body. Blood flows into the penis. However, instead of being trapped in the penis, the blood flows back out. This is where the term “leak” comes from.

Of course, the condition is not a literal leak. It simply means that veins are not being constricted, allowing blood to flow out of the penis. You might think of a venous leak as a faulty valve.

There is still a lot that is not know about venous leaks, but there are a number of things that can cause the condition:

• A breakdown in the tissues within the corpus cavernosa, the spongy tissues that become inflated with blood during an erection. This is sometimes caused by low testosterone.
• Weakness of the muscles which prevent blood from flowing out of the penis during an erection.
• Physical damage to blood vessels, which may be due to an accident or trauma.

Diagnosis

A venous leak is often diagnosed using an ultrasound or CT scan, which allows doctors to directly observe blood flow within the penis.

Treatments for Venous Leak

Men with a venous leak may not respond to oral medications (PDE-5 inhibitors), which are the primary treatment for erectile dysfunction. Alternate treatments may include:

• Testosterone Replacement Therapy (TRT), which studies have shown to be an effective treatment in some cases.^{1 2}
• Shockwave Therapy, using treatment protocols specifically designed for treating venous leaks.
• Surgery to correct physical defects.

References

1. Kurbatov, Dmitry; Kuznetsky, Jury; Traish, Abdulmaged. “Testosterone improves erectile function in hypogonadal patients with venous leakage.” Journal of Andrology. Nov-Dec 2008; 29(6):630-7.
   <https://pubmed.ncbi.nlm.nih.gov/18599885/>
2. Yassin, A A; Saad, F. “Dramatic improvement of penile venous leakage upon testosterone administration. A case report and review of literature.” Andrologia. Feb 2006;38(1):34-7.
   <https://pubmed.ncbi.nlm.nih.gov/16420241/>