Venous leak

Venous leak, also known as venogenic erectile dysfunction or veno-occlusive insufficiency, is a disorder that occurs when the penile veins are unable to store enough blood to maintain an erection. There are two types of venous leak:

• Organic: caused by an underlying physical problem such as vascular or neurological lesions
• Psychogenic: linked to emotional, psychological or relational factors

This category of erectile dysfunction has a significant impact on patients’ quality of life. Fortunately, effective solutions are available to treat impotence and restore erectile function, allowing patients to resume a fulfilling sex life.  

Venous leak manifests through difficulty in achieving and maintaining an erection firm enough for satisfying sexual relations. Symptoms vary depending on the origin:

• Organic: persistent erectile dysfunction in all situations, including during masturbation. The inability to maintain a satisfactory erection is constant, regardless of the context.
• Psychogenic: Morning and nocturnal erections are normal, suggesting that basic erectile function is intact. Problems mainly occur during sexual interaction with a partner.

These symptoms go beyond physical appearance. They can have a considerable emotional and psychological impact, causing frustration, anxiety and low self-confidence.

Impotence due to venous leak can be caused by multiple factors, such as:

• Pelvic or perineal lesions that alter the structures and blood vessels necessary for an erection
• Insufficient blood flow to the penis, resulting in a soft erection
• Neurological factors: any injury to the cavernous nerve, whether sensory (causing loss of tactile sensation, for example) or motor (altering the ability to achieve an erection) can cause erectile dysfunction
• Psychological factors: stress, anxiety and depression can interfere with sexual response
• Underlying medical conditions: diseases such as diabetes or prostatic hyperplasia (enlarged prostate) affect erectile function
• Testosterone deficiency: reduced levels of this hormone, which plays a key role in sexual function, can cause erectile problems

It should be noted that these factors may overlap. An in-depth medical examination by a qualified professional must be performed to determine the causes specific to each patient. This individual assessment is necessary to set up an effective treatment for male erectile dysfunction.

Venous leak is diagnosed based on a thorough clinical evaluation, possibly combined with additional tests, such as:

• Psychological evaluation to identify underlying emotional factors
• Blood tests to measure hormone levels
• Doppler ultrasound to assess penile blood flow

This personalized approach allows us to determine the condition’s underlying cause and to develop a customized treatment plan for each patient.

Several solutions are available to treat erectile dysfunction, adapted to the patient’s particular situation:

• Oral medications: Phosphodiesterase type 5 (PDE5) inhibitors are medicines that boost blood flow to the penis. They help achieve a satisfying erection while offering a solution that is discreet and easy to use.
• Penile injection therapy: Medication is injected directly into the penis to dilate the blood vessels and effectively stimulate an erection.
• Vacuum erectile devices: These devices create a vacuum around the penis, pulling blood into the organ to create an erection.
• Embolization: Minimally invasive interventional radiology alternative that treats venous leak by blocking the veins that are causing the leakage of blood. This technique restores sufficient blood flow to the penis to maintain an erection.
• Penile implants: When other treatments fail to produce the sought-after results, penile implants are a viable option. Surgically implanted directly into the corpora cavernosa, they enable the patient to get an erection whenever desired.

At the American Hospital of Paris, we offer a range of treatment options for erectile dysfunction to help you return to a confident and satisfying sex life. Your preferences, overall health and the factors specific to your situation are taken into consideration to guarantee that you receive the care most suited to your individual needs.