Penile Venous Insufficiency (Venous Leak)

Penile venous insufficiency (venous leak) is the inability to maintain firmness because blood that fills the penis during erection cannot be adequately trapped. It is one of the vascular causes of erectile dysfunction.

In a normal erection, blood that fills the penis is trapped as the veins temporarily close. In venous insufficiency this trapping mechanism does not work well; the erection starts but cannot be maintained. Typically the person gets an erection but loses it quickly.

Diagnosis is supported by detailed assessment and, when needed, colour Doppler ultrasound.

Symptoms

• Getting an erection then losing it quickly
• Firmness decreasing faster while standing
• Limited response to oral medication
• Difficulty completing intercourse

Causes

• Individual differences in vascular structure
• Age and conditions affecting vascular health
• Association with Peyronie's or tissue changes

When Should You Seek Help?

If you can get an erection but not maintain it, and standard treatments give an inadequate response, advanced vascular assessment may be needed.