Patient's question:
Dr. Yu, hello. I am 26 years old and I had a Doppler blood flow test for my penis in a regular hospital. The doctor said I have a venous fistula. I usually have sexual desire, but when I have sex with my wife, my penis does not spontaneously erect. Even if I manage to get an erection, it will get soft when I stand up to prepare to enter. It only gets hard when stimulated, but it gets soft very quickly when I stand up. My previous sexual life has become very vague, and I almost never had sex before. It has been more than a year since I started having more frequent sex, but many times my penis cannot erect at will and I cannot change sexual positions. I am under a lot of pressure and often think in my mind whether I will not be able to perform in the future. After all, I am still young. Poor sexual performance may lead to the failure of my marriage. I have a history of masturbation for four years. My wife often wakes up at night and asks me to help her. She says that when she wakes up, she sees my penis is hard. I also have morning erections, but they are not every day. And after morning erections, they get soft when I get up.Doctor's answer:
This situation is generally caused by insufficient blood supply to the penis due to inadequate pressure within the corpora cavernosa, which fails to block venous. If the arterial blood supply is sufficient, the pressure in the corpora cavernosa would be enough to prevent this phenomenon. Therefore, selective penile arterial dilation drugs can be used to improve blood supply to the penile arteries, normalize cavernosal pressure, and effectively block venous. Tadalafil can be taken before each sexual activity, and continuous treatment for 4-6 weeks can improve penile arterial blood supply, thereby alleviating the symptoms of the so-called venous leakage. Additionally, psychological factors can also affect penile arterial blood supply, so it's important to relax during sexual activity. For someone of your age, the treatment method of implantable devices should be approached with caution. I believe this method is more suitable for patients over 50.