Venous Leak: Difficult to Treat Cause of Erection Problems in Men  

by Alex Shteynshlyuger MD

When it comes to the treatment of erectile dysfunction – New York Urology Specialists are a step ahead.  Better Science Means Better Care.   

If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

Venous Leak Causes Problems with Obtaining and Maintaining Erections in Men

What is Venous Leak or Veno-Occlusive Insufficiency?

Erections are caused by increased blood inflow to the penis.  The decreased outflow of blood from the penis allows an erection to be maintained. The maintenance mechanism that prevents blood from leaving the penis is the ‘corporo-occlusive” mechanism within the penis that involves collagen fibers, smooth muscle, and other support structures.

Venous leak refers to the failure of the corpora-occlusive mechanism within the penis to keep blood from leaving the penile shaft. 

Corporo-venous occlusive erectile dysfunction or veno-occlusive dysfunction can be caused by degenerative changes of tunica, changes to collagen components as a result of aging, Peyronie’s disease, diabetes or penile fracture.  

Decreased smooth muscle content may also contribute to venous leakage. Decreased amounts of elastic fibers and increased collagen deposition are thought to be major contributors to ‘venous leak”.   Decreased smooth muscle can contribute to ED.  Trauma may also induce abnormal venous shunts that impair occlusive venous mechanisms in the penis.  This is also called ‘cavernosal’ ED because the problem originates in the mechanisms responsible for the maintenance of erection within the corpora cavernosa of the penis.

What are the Signs of Venous Leak Erectile Dysfunction?

A venous leak, or veno-occlusive insufficiency as it is more formally known, can occur as mild, moderate or severe problems contributing to erectile dysfunction in men.  When a venous leak is minor, it is often asymptomatic, as long as blood inflow is good, it can compensate for veno-occlusive insufficiency.

The most common symptoms of erectile dysfunction caused by a venous leak are erections that cannot be maintained, engorgement but no erection after taking medications such as Viagra or Cialis.  It is important to understand that men without venous leak but with arterial insufficiency can also experience similar symptoms.

How is Venous Leak Diagnosed?

A venous leak is suspected as a cause of erectile dysfunction in men who able to obtain erections but lose it very fast.  Veno-occlusive insufficiency is also suspected when medications such as Viagra or Cialis does not work well.

A definitive diagnosis of corporo-venous occlusive erectile dysfunction is made using penile Doppler ultrasound with an intra-cavernosal injection of prostaglandin or Trimix.  End-diastolic velocity, a parameter measured by duplex ultrasound, is typically greater than 5 mL/s in patients with a venous leak.  Normally, EDV (End-diastolic velocity) is less than 5

It is important to understand that severe anxiety can produce false results. Similarly, an inadequate dose of Trimix or prostaglandin can suggest veno-occlusive insufficiency when the problem may be related to arterial insufficiency or combined problem. Redosing with a higher dose of Trimix or SuperTrimix is usually advisable when the diagnosis is uncertain.

What are the Treatment Options for Fixing Venous Leak?

Veno-occlusive dysfunction is one of the most challenging problems to treat.  For some patients with a mild venous leak, medications such as Viagra or Cialis might work.  Using penile constrictive ring might allow men to maintain erections for a prolonged period of time.  Some men are successful in using vacuum erection devices or penile injections in combination with a penile constrictive ring.

For most men with moderate to severe erectile dysfunction caused by veno-occlusive insufficiency or combined erectile dysfunction caused by arterial and veno-occlusive insufficiency, penile implant offers the most effective treatment option

Inflatable penile prostheses such as AMS-700 and Coloplast Titan OTR penile implant enable men with a severe venous leak to resume sexual activity.  The penile implant offers excellent effectiveness for the treatment of moderate-severe venous leak and mixed vascular erectile dysfunction even when medications such as Viagra and Cialis do not work

Ineffective Treatment Options for Men with Venous Leak or Mixed Vascular Insufficiency

It is important for men to understand that certain treatments will not be beneficial if a venous leak or veno-occlusive insufficiency is the underlying cause of ED. Similarly, if there is a combined vascular insufficiency with poor blood delivery (arterial insufficiency) and failure of blood to remain in the penis (venous leak), the severity of erectile dysfunction tends to be more severe.  Many men come to us after trying multiple treatments for ED without success. Many men resort to expensive and ineffective treatments such as plasma and platelet injections for ED.

The following treatments are ineffective in men with a moderate-to-severe venous leak or mixed vascular insufficiency:

Medications such as Viagra and Cialis that are offered online by outlets such as GetRoman and others are typically ineffective for men with veno-occlusive erectile dysfunction. Trimix injections offered by Boston Medical, as well as at New York Urology Specialists, often result in semi-erection of 40-60% hardness but not adequate for intercourse.

Shockwave therapy for ED typically does not lead to a significant benefit in men with a moderate-to-severe venous leak.  Similarly, the platelet injections are of no benefit to men with veno-occlusive vascular insufficiency or venous leak as the underlying cause of erectile dysfunction.

Can Surgery Fix Venous Leak?

Surgical treatment has been tried to correct veno-occlusive insufficiency.  Currently, the surgeries are not recommended because long-term success beyond 1-2 years is poor and most men require additional treatment.

Where to Get Treatment for ED in NYC?

At New York Urology Specialists, we offer specialized treatment for ED for men. Same-day appointments are available.

Call/text today: 1-646-663-5211 or make an appointment online.  

We treat sexual and erection problems and offer comprehensive STD testing for infections.  We treat penile problems in men, including phimosis, balanitis, penile irritation, and penile redness. We perform a no-scalpel vasectomy, vasectomy reversal, cosmetic circumcision, circumcision revision, penile frenuloplasty. We offer confidential appointments.

Our prices are ED treatment prices are affordable with or without insuranceLow-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.  We offer free insurance verification.

Read Real Stories of Men who Underwent Treatment for ED at New York Urology Specialists.

We offer ED treatment to patients within driving distance to our offices as well as from other states and countries.  Our patients come from New York, New Jersey, Pennsylvania, and Connecticut, and over 30 countries worldwide.

What do Penile Problems Look Like?

You can find pictures of penile problems including before and after treatment images in our image gallery.

What You Need to Know:

Why Choose New York Urology Specialists for Treatment of Erectile Dysfunction?

  • All treatment is performed by a board-certified urologist experienced in treating men with symptoms of ED, premature ejaculation, and other sexual problems using medical therapy, minimally invasive therapies, lasers, and surgery.
  • We are one of the few practices in the region to offer a full range of options for the treatment of sexual and erection problems in men.
  • We offer diagnostic testing in our office which avoids hospital costs.
  • Extensive Experience: Thousands of men have treated successfully using medical therapy, shockwave therapy for ED, penile injections with Trimix, and penile implant surgery.
  • Confidential and Understanding Care. We understand that most of our patients desire privacy.  We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
  • We are one of the few practices in the region to offer a full range of options for the treatment of sexual and erection problems in men.
  • We are conveniently located within 30-60 minute commute to men who are seeking ED treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.

Scheduling Appointments for ED Treatment at New York Urology Specialists

If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

We offer weekday, weekend, and evening office hours.

Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation, and other sexual concerns.  He has successfully treated hundreds of men with sexual problems including ED and poor libido.

Patients Reviews

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Patient review
by on Jan 24, 2020

Peronis Disease
by on Aug 04, 2019

Dr Alex was both knowledgeable and concise with his diagnosis and advice which was well received. Dr was her knowledgeable in the subject and provided good advice.

3P Removal
by on Jul 24, 2019

Went to get my penile papule remove. Got done same day, it was fast, great staff, and most importantly, pleased with the result.

by on Jul 18, 2019

Therefore I would like to recommend you to anyone who need your services.

Urology Visit
by on Jul 18, 2019

Staff were all very welcoming. Dr. Alex Shteynshlyuger was very knowledgeable and attentive during my time spent with him.

by on Jul 09, 2019

Went in for a procedure with Dr. Alex and he was very calm and thorough about the the operation and the recovery. From the front desk to his assistants, everyone was very courteous, professional and polite. I highly recommend NY Urologist Specialist. They are outstanding!!!

Friendly , courteous, effiecient and professional
by on Sep 15, 2018

Wyts Wyts recommends New York Urology Specialists via Facebook. September 15, 2018 · Friendly , courteous, effiecient and professional staff members. This office i highly recommend for any and all Urology matters. Dr Alex Shteynshlyuger is very professional and knowledgable easy to communicate with. Thanks Dr Alex

Satisfied Patient
by on Sep 15, 2018

I am very please and satisfied with everything that has been offorded to me by New York Urology Specialist Office.....Dr Alex

Surgical Procedure
by on Sep 01, 2018

Dr Alex and his staff are through professionals in every sense of the word. From initial diagnosis to a period of evaluating and ruling out options, we decided upon a surgical solution, which appears for the most part to have corrected the issue. Thanks to Ana, and the staff, especially Dr. Alex for treating me so well. Best regards, Lee

by on Aug 16, 2018

Outstanding service

A very good doctor
by on Aug 15, 2018

Dr. Alex Shteynshlyugerand is careful, patient, experienced. Uses innovative approaches, that actually yield results. He is indeed a good doctor, in every sense

urology services
by on Apr 11, 2018

I am very satisfied with the treatment I received at new york urology specialist and would recommend them to other patients.they are the very best.

My wife was elated
by on Jan 15, 2018

Well I put it to use last night and man, good job. My wife was elated. u made it much better somehow, so thank u for fixing my penis

by on Dec 05, 2017

"Cannot express how thankful I am I found Dr. Shtetnshlyuger. After undergoing surgery to correct a penile torsion I couldn't be happier with the results. A great doctor who is clearly good at what he does. With something as important as your private area, It's nice to be able to rest easy and know you are in good hands.." via 12/5/2017

by on Nov 19, 2017

I am writing to thank dr. Alex. He is thorough, professional, knowledgeable, helpful and friendly. I have seen him for ED and prostate issues, and he has explained all my options clearly, and found solutions that have been a great help. thank you! I highly recommend both Dr. Alex and his staff, which I find to be helpful, friendly, knowledgeable and very professional. They are a pleasure to deal with and all have been a great help.

Dr visit
by on Sep 14, 2017

I am very much thankful for meeting Dr Alex .I had a very serious medical problem I visited many doctors but none could not help me it was very difficult for me until I visited Dr Alex after a couple visits my medical problem is no more I feel very great also I felt almost 20 years younger Dr Alex is second to none fantastic doctor. Thanks again Dr Alex from my family.

Excellent doctor
by on Jul 03, 2014

I am feeling better now after visiting clinic New York urology specialists. Excellent staff and appointment on time.

Thank you for excellent care
by on Jan 07, 2013

Dear Dr. Alex: We want to thank you for the excellent care you provided for George during his emergency operation and the follow up treatment. Your quiet, confident manner was reassuring to us during a very scary time for us. We will never forget you. George Sally R. Date: 2013

We love you!
by on Feb 16, 2012

Dr. Alex Shteynshlyuger and Staff – Thank you so much for taking care of my husband Bob. Dr. Alex: I thank God everyday for you. You were an answer to prayer.

ED is Treatable in Nearly Every Man

Excellence-Urology_Care-banner2At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of erectile dysfunction.  We understand the challenges that ED creates for our patients, their relationships, and their self-esteem.  We help you find a treatment for erectile dysfunction that fits your needs, lifestyle, and your preferences.

Urologists are doctors specializing in the treatment of men with erectile dysfunction. By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED.  We offer medical and surgical treatment for erectile dysfunction.

We Treat Some of the Most Complex ED Problems Including:

Schedule an Appointment with Dr. Shteynshlyuger:

Call/text today: 1-646-663-5211 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship-trained board-certified urologist with expertise in the evaluation and treatment of sexual and erection problems in men using modern effective and proven treatment methods.  We offer inflatable penile implant, shockwave therapy for ED, and treatment for Peyronie’s disease.

He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.

If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

We offer weekday, weekend, and evening office hours.