Sexual medicine

sexual medicine TREATMENTS

Venous leakage

Among the multiple profiles of patients with Erectile Dysfunction that we received in our Madrid, Seville and Canary Islands office, cases which presented with Venous Leaks happened to be among the most complex to diagnose and treat due to their nature. Fortunately, as you can see in this 5-minute video, or read in detail below, the new generation technical advancement we have at our Andromedi Clinics in Madrid, Seville and the Canary Islands has brought revolution to how this disease is diagnosed and treated.


Table of Contents

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What is it and What are its causes?

Patients suffering from male impotence (or erectile dysfunction) can be divided into four large groups, depending on the causes: psychological, hormonal, pharmacological or vascular. Although the Venous Leak could result from multiple causes, it often corresponds to the last group since it is mainly described above all as a physiological problem. Certain cases, such as a young 23-year-old man with severe Erectile Dysfunction who finds it impossible to maintain a normal sex life are usually very emotional.

To understand what this ailment is and why it appears, we must start by looking at how the male system starts and maintains an erection. The explanation is quite technical, so we will try to describe it in the simplest of terms.

Anatomía del pene en reposo

Anatomía del pene en erección

Once sexual excitement commences from visual, tactile or sound stimuli, the nervous and circulatory systems increase their activity. Blood vessels carry blood to all parts of the penis and the sinusoidal spaces act as gates to “tighten” the veins and thus maintain the hardness of the erection. It is at this point that some men experience a Venous Leak or “failure of the corporal veno-occlusive mechanism”. The peripheral areas don’t close properly causing the erection to be lost partially or completely as the blood escapes for physical reasons and not because excitement is lost. When this happens, the excitement does not contribute to the rigidity in the erection of the penis.

Irrigación sanguínea del pene que presenta fuga venosa

Irrigación sanguínea normal del pene en erección 

This type of dysfunction can result from several different causes with certain isolated cases resulting from multiple causes in combination.

Puede presentarse de nacimiento (de origen congénito)

Puede presentarse de nacimiento (de origen congénito)

Por haber sufrido un golpe o traumatismo severo

Por haber sufrido un golpe o traumatismo severo

Patologías diversas que puedan afectar el sistema circulatorio

Patologías diversas que puedan afectar el sistema circulatorio

It could appear from birth (of congenital origin) Suffering from a serious blow or trauma Numerous pathologies that may affect the circulatory system
The abusive use of penis extenders without medical supervision or the poor execution of penile manipulation exercises (massages for penis enlargement), known as Jelqing techniques

Venous Leak

Treatment Summary

Here is a summary of the approximate process from the time you make your appointment to receiving the medical discharge after the treatment in some our Andromedi centers in Madrid, Seville or Canary islands (Tenerife).

Necessary Consultations

Generally three consultations: one to assess the problem by talking to the patient, one for a CT angiography and one for preoperative assessment.

Hospital Stay

After surgery, the patient must remain in hospital for at least 24 hours for the doctor to assess recovery.

Type of anaesthesia

Local anaesthesia is most commonly used for this procedure, in addition to some general sedation to relax the patient.

Intervention Time

The surgery almost always lasts between 45 minutes and an hour and a half. It all depends on the degree of vascular involvement of the penis.


The postoperative period usually lasts up to one month after surgery and the patient should avoid strenuous activities such as running.

Normal Life

Sexual intercourse should also be avoided for some time. Most doctors recommend one to two months of abstinence.


Diagnosis of the Venous Leak

If you are suffering from Venous Leak and decide to surf the Internet for information about the possible solutions to this pathology, it will most likely result in a bittersweet feeling. True as it may be, it has never really been easy to treat.

The main reason for this has been the diagnostic system which until now (though still in use at other centers), wasn’t effective in identifying the exact blood vessels affected before possible surgical intervention. However, this trend has changed remarkably in recent years in our practice to the extent that we have recorded an increase of more than 60% in successful surgeries just in the last few months.

During the first consultations, the Doppler ultrasound serves as a simple and affordable tool used in immediately assessing for the possibility of this condition.

The real problem is usually in the next phase which involves specific identification of the affected vessels. The formerly used Cavernosography (two-dimensional image) and Cavernosometry (blood pressure measurement) fail to provide the required level of detail with a 2D image. Today, our advanced diagnostic technique has proven to be a lot more effective: it is multi-detector CT angiography with 3D reconstruction, which enables easy identification of the specific veins that require ligation.

Resultados positivos de una fuga venosa en imagen diagnóstica con angio-TAC-3D Helicoidal.
Resultados positivos de una fuga venosa en imagen diagnóstica con eco doppler

Thanks to this new three-dimensional CT that we have been using for months in our consultations in our clinics of Madrid, Seville or Canary Islands, the surgeries we finally approve are those with a high probability of success. However, within a few seconds of reviewing the results of the Helical CT of certain profiles, we contemplate over recommending penile prosthesis as the best solution, because the surgery might not be safe or present with low chances of success. This helps us offer the best solutions to our patients for their particular cases.

Approximately, 30% of people can benefit from surgery, either to completely solve the pathology or to delay the arrival of the penile prosthesis while helping them maintain their erections. We have seen quite severe damages caused by the aforementioned dangerous jelqing techniques. Damages that were irreparable in the operating room even when the patient was young.

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This CT (Computed Tomography) scan is not painful, it is relatively fast (between 20 and 40 minutes) and requires no hospital admission. It is capable of diagnosing effusion in all types of venous leaks (Deep Dorsal Vein, Superficial Dorsal, or Massive).

Evaluación médica

Venous Leak - Treatment and solutions

As mentioned above, there are two main solutions to this pathology, depending on the results of the test with the Angio CT 3D.

Surgical treatment of venous leakage, if feasible, is much cheaper than the penile implant because in the latter, we need to deal with the expenditure of material that involves a next-generation implant such as the Coloplast prosthesis we use. Nevertheless, our main goal is always to give the patient back his erection, so in reality, it is not a matter of price or budget, but suitability marked by medical indication.

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Testimonios de pacientes de Fuga Venosa en Andromedi

Emilia Clarke
Tengo 34 años, y desde hace años tenía problemas de disfunción eréctil, hasta el punto de no ser capaz de mantener una erección tomando medicación oral e incluso inyectada. No podía mantener una relaciones sexuales. Tras consultar con varios urólogos y realizar una eco doppler de pene, se me diagnosticó disfunción eréctil por fuga venosa. Tras visitar varios urólogos, algunos de renombre, me indicaron que no había un tratamiento efectivo para la dolencia, ofreciéndome únicamente la opción de la prótesis de pene, la cual no es reversible y considero poco adecuado para mi edad. Uno de ellos me recomendó al Dr. Cruz, el cual me realizó una cavernografía-tac muy especializada y sostuvo que la fuga venosa, el lugar por donde se escapaba la sangre que debía mantenerse en el pene, para que mantuviese la erección, estaba localizada en una vena específica, y que mediante cirugía podía revertir dicha situación. Dicho tratamiento era muy innovador y poco conocido, pero tras consultar a diferentes especialistas y no conocer otra solución, decidí operarme. El resultado, transcurrido un año de la operación, es asombroso. Tras pasarse el efecto de la anestesia y literalmente desde la primera noche, comencé a tener erecciones involuntarias. Tras un periodo de recuperación de aproximadamente mes y medio, volví a tener y mantener erecciones normales, tras mucho tiempo volví a mantener una vida sexual normal. Pasado un año de la intervención por fuga venosa, quería ponerme en contacto con el equipo para indicarles que el tratamiento ha sido un éxito con erecciones que se mantienen de forma normal, sin dolor, ni efectos secundarios. La eficacia de la operación ha sido total. El trato con el Dr. fue en todo momento cercano y profesional. Como efectos secundarios, únicamente he notado los propios del postoperatorio tan sólo en los días posteriores. Los más molestos son los derivados de las erecciones durante las primeras dos o tres semanas de la intervención, que al tener puntos de sutura provocaban dolor. En cuanto se cayeron dicho dolor desapareció. En resumen, todo perfecto. Gracias.
Paciente Fuga Venosa
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Frequently asked questions at the Andromedi centres in Madrid, Seville and Tenerife



Are there cases in which it occurs in combination with other problems that affect erection or sexuality?

If several symptoms appear in the same patient, this does not necessarily mean they are related. For example, if there’s Venous Leakage with Premature Ejaculation or Infertility, it is very likely that there is no relationship between them. However, if you have an acquired curve (Peyronie), the connection should be studied since there is probably a direct relationship due to a structural problem in the penile anatomy. Here is another example that may be related; in addition to the vascular problems typical of this disease, a significant number of patients present with anxiety problems related to sex because they are men who experience much frustration from their sexual relations.

What’s the price? How much does the entire treatment cost?

We know that people who come to our website ask for a specific figure to get a quick idea about the cost, but unfortunately, like is the case with other treatments, it is difficult to provide this because first, you have to diagnose the extent of the problem for each case. At the Andromedi Clinic, we believe that giving a budget that does not work for everyone equally (which can increase or decrease with the medical discoveries we make during consultation) is something that, besides being unethical, can frustrate the people concerned.

With treatments like vasectomy, where all patients receive very similar care, we can give an almost definitive figure. But in this case, each patient is different since there are multiple variables that affect a clear answer about “how much it costs”. We believe that medical practice, including the important economic point, should be something more human, more personal, with greater patience and dedication.

You can request for an individualized quote without any obligations through the contact area of our website, through the e-mail or telephone 648 862 033 (with prefix +34 for international calls). We will be happy to help you find the best way to carry it out.

Is it covered by Social Security? Is there any health insurance at the Andromedi clinic?

Currently, this treatment is mainly offered in the private sector, since Spanish Social Security covers only certain cases and especially in certain Autonomous Communities. We advise that you request information locally to see if you can benefit from that coverage.

As for medical insurance at our Clinic in Seville, we do not work with any of them because our center is 100% independent.

I’ve seen adverts about using low-intensity shock waves to treat this ailment. Do shock waves really work?

Generally, venous leakage patients don’t have the ideal profile to receive shock wave treatment. The best solution for this condition is specific surgical intervention. It might not be harmful and could end up helping to increase the erectile capacity, although this treatment is not for this pathology.


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