Men's Health

Venous Leak: Symptoms, Causes, and Treatment

Fact Checked

A venous leak is a defect where a man can't have strong erections even with sufficient blood into the penis. Are you at risk of this condition and what can you do about it?

Last Updated: 05/09/2025

Written by

James Lang

Medically Reviewed by

Dr. Paul Thompson, M.D.

Today, many men silently suffer from erectile dysfunction. If you find yourself experiencing difficulties sustaining erections, the potential cause is that you might be struggling with a venous leak.

Much concerning venous leakage remains contentious among physicians, and many facets of the disease, notably its medication options, are debatable. The prevalence of the illness is unclear, yet, a few resources suggest it's a prevalent underlying cause of erectile dysfunction. The medical term for this type of ED is venogenic erectile dysfunction or penile venous insufficiency. It can have a significant impact on men's well-being.

Venous Leak: What Causes It?

A venous leak is a defect where a person can't have strong erections even with enough blood flow into penile veins. It results from too much venous drainage in the penis corpora cavernosa. This retards the typical erectile capability of the man organ.

To maintain an erection, the genitalia has to store blood and restrict outflow through compression of penile veins taking the blood back to maintain a strong erection. This process is called veno-occlusion. If a man has venous leakage, the blood won't hold, thus making the erection fluid. Such a person may have an erection but can't keep the erection firm for long.

Men suffering from venous leakage experience shame and often choose to be secluded in sexual relations. If you have a possibility of contracting the condition, talk to your doctor. Get an early diagnosis since venous leakage is treatable.

Some of the causes of venous leakage include:

  • Vascular disease (which affects blood vessels) causes the vessels not to contract. Therefore, blood won't hold to give a firm erection. In some instances, you may have erections, but you won't be able to keep them.

  • Radiation therapy for cancer treatment. If you are a cancer patient receiving this type of medication therapy, there is a chance that you may contract or may have contracted a venous leak, which is causing your erectile dysfunction problem.

  • Diabetes - Diabetic persons are at high risk due to their sugar levels vulnerability, causing blood not to adequately function and hold at the penis for an erection.

  • Peyronie’s disease

  • Nerve disorders

  • Anxiety causes an imbalanced flow of blood. During an erection, blood must consistently flow into the penis and hold. Anxiety attacks stop the blood from staying in the penis.

Symptoms of Venous Leakage

Venous leakage can affect men of all ages, although some of the symptoms that increase your risk like diabetes or vascular disease are more likely to happen in men over 40.

Venous leakage symptoms include:

• Erectile dysfunction

• Shortening or narrowing of penis length

• Soft glans of the penis during erection

• Erectile rigidity that's dependent upon your position

Diagnosing Venous leakage

Venous leakage can be diagnosed in a patient using different medical techniques. These are certified methods used by doctors worldwide to check for this condition that affects the manhood of males. Research has shown that many men with erectile problems suffer in silence and only come for a checkup when they can no longer sustain a sexual erection, and thus, their sexual life is in ruin or on the verge of collapse.

If you show any symptoms of venous leak and have conditions and diseases that increase your risk, your doctor may order testing.

The following are the common conventional ways used to detect venous leakage:

Dynamic infusion cavernosometry

In this case, fluid is pumped into the genitalia at a predefined rate and pressure. It measures the vascular pressure in the corpus cavernosum when erect. A vasodilator, such as Prostaglandin E-1, is given to determine the infusion rate required to achieve a stiff erection and to help determine the severity of the venous leak. Cavernosography supports this treatment, which involves injecting a contrast agent and then x-raying the patient to detect any leakage.

Penile Doppler ultrasonography

A Doppler ultrasound is a noninvasive diagnostic that assesses the blood flow through your arteries by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. A normal ultrasound employs sound waves to make pictures, but doesn't show the blood flow.

A venous leak diagnosis may be given incorrectly by a penile colour doppler procedure. Extreme caution should be in place when giving DUs to young patients with no history of vascular risk factors. Failure to achieve a decent erection should make the clinician hesitant to diagnose the venous leak. Furthermore, cavernosometry, which looks to be more precise in detecting venous leakage, continues to play a role in accurate diagnosis.

Overall health and conditions related to erectile dysfunction (vascular disease, diabetes, Peyronie’s disease, and nerve disorders)

People suffering from diseases that interfere with normal body function, such as diabetes and nerve disorders, have a high chance of having a venous leak. If a person suffering from ED has such a disease, 90% of the time, a venous leak is the underlying cause of erectile dysfunction.

Is venous leakage curable?

Venous leakage is treatable. Medical doctors and scientists have come up with treatment methods for this condition and have been able to restore the traditional function ability of the penis to persons suffering from a venous leak. Thanks to early diagnosis and effective treatment strategies, there has been a significant decrease in the number of men suffering from erectile dysfunction and venous leak. Venous leakage treatments include:

1. Oral erectile dysfunction treatments

The FDA (Food and Drug Administration) has approved drug therapy for treating erectile dysfunction (ED). They must be taken orally and in tablet form to be effective. These drugs aid in the smooth muscle relaxing to produce an erection.

The medication, however, is less effective in men who are suffering from severe cases of venous leak.

2. Penile injection therapy

When oral medicines are unsuccessful, penile injections are also effective for treating impotence. Although the notion of having anything injected into your penis is without a doubt unpleasant, many men will attest to the injections' effectiveness and simplicity.

Urologists also employ a mix of medicines, including papaverine, phentolamine, and alprostadil, in addition to the two FDA-approved treatments, Caverject and Edex. In most situations, injections consist of a mix of two or three medicines. This combination, dubbed Trimix, enables the three medicines to work synergistically while keeping the doses of each treatment low enough to avoid adverse effects. Additionally, the Trimix solution has a reaction rate of up to 90%. Only 0.7% of persons getting intracavernosal injection fail to have an erection.

Before commencing home injectable treatment, you must get adequate training and information from your physician. The injectable medication's purpose is to maintain an erection long enough for sexual intercourse, but not too long or too painfully. The injections must be given in the correct quantities and using a suitable technique to avoid scarring the penis or developing priapism (an erection that lasts more than four hours).

3. Urethral suppositories

When oral medications fail to work, the medicated urethral system for erection (MUSE) is commonly used as a treatment option for erectile dysfunction. This approach includes putting a small suppository of medication into the penile urethra without the need for needles, which is a significant advantage over other methods. It is then absorbed, which aids in the creation of an erection as well as the maintenance of it.

In major clinical studies conducted in Europe and the United States, it was discovered that MUSE was beneficial in 43% of men who had impotence owing to a variety of causes. Patient or spouse administration is the primary advantage of this medication, which has low side effects and is delivered locally. Despite this, it has been demonstrated that the therapy causes substantial long-term penile pain and that the response rate is highly varied. An adjustable rubber tension band is occasionally utilized at the base of the penis to help get the best possible results.

Patients who use MUSE should have their initial application done at their doctor's office to avoid complications such as urethral hemorrhage, low blood pressure, and sustained and extended erections, among other things. Additionally, in rare instances, the symptoms of lightheadedness or low blood pressure may manifest themselves.

It's also worth noting that sexual stimulation is necessary after inserting the suppository into the penile urethra to increase flow to the penis and relieve discomfort. Only one suppository should be used each day, and medication stored in the refrigerator.

4. Penile implants (penile prosthesis surgery)

Penile implants are functional devices carefully and strategically placed inside the penis. It is a common surgical method for treating erectile dysfunction.

The insertion of a penile implant is an option when erectile dysfunction has a defined medical etiology and when the issue is improbable to resolve or naturally improve in conjunction with other medical therapies. When scarring causes erections to curve, a penile prosthesis may be inserted during surgery to restore the penis.

Patients have the flexibility of selecting from a variety of inflatable and malleable medical devices. Depending on the anatomy and preferences of the patient, a range of implantation procedures can be used successfully. Patients who have not responded to more conservative treatment options are the focus of this treatment.

Penile prosthesis implantation in patients with any of the following conditions is contraindicated:

  • Active infection throughout the body, especially urinary tract or genital illness

  • Unresolved urination difficulties such as increased residual urine volume owing to the blockage of the bladder or bladder exit

  • Patients unwilling to undergo device overhaul operations

Complications associated with penile implants are:

  • Uncontrolled bleeding following surgery; this condition may necessitate further treatment.

  • Infection- very rare

  • Formation of scar tissue

  • Displacement of a pump or reservoir- as a result of the pump not being fixed firmly during surgery

  • Mechanical breakdown of the apparatus.

The success rates for male penile implants are high, with only 1% of the patients having infections and complications later on. The mechanism's longevity is usually 15 years, after which you will need to get another implant.

5. Lifestyle changes

If the venous leak is mainly due to stress, your doctor may suggest that you try relaxation techniques. A professional therapist will help you to deal with stress, anxiety, fear, or grief. These may be causing irregular blood flow, causing you to have a venous leak. You can also plan to visit a sex therapist who will guide you on the best approaches to coping with sexual disappointments and maintaining composure during intimacy. Successful treatment helps you and your partner manage your challenges.

Other important lifestyle changes include quitting smoking, regular exercise, and eating a balanced diet low in sugar and high in fruits and vegetables. These can all improve blood flow to the penis and lead to a more satisfying sex life.

6. Venous ligation surgery

Venous leak surgery, such as crural ligation and penile revascularization, is included in the category of vascular surgery. There is no alternative therapeutic method that can result in a permanent reorganization of typical spontaneous erections in the absence of medications or medical technology to consider. Vascular surgery is the only treatment option available with this capability.

Conclusion

Erectile dysfunction is caused by a myriad of conditions and diseases. Venous leak is one of the causes that can lead to loss of erections or weak erections and erectile dysfunction. Lack of sexual satisfaction is linked to this, since men who have venous leak mayl not satisfy his partner nor himself.

The good news is that venous leaks are diagnosable and treatable. After you experience any of the symptoms associated with venous leaks, such as nerve disorders and Peyronie’s disease, you need to get checked for this disease. This will prevent a possible erectile failure that may negatively affect your lifestyle. Scientists have curated the possible ways of treating this condition and restore manhood to wholeness. This includes oral medications, penile implants, and surgeries, among others.