Dr. Vaibhav Vishal
Urology
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Patient's Query
Hi doctor,
I am 31 years old. I am a healthy, active person with no sugar or heart issues (done screening) with no LDL or triglyceride problem. However, I am suffering from two issues. First, when I masturbate, I get erections. I also get morning erections (not daily). But during sex, sometimes I lose erections, and I am not able to ejaculate during intercourse. The second issue is I am suffering from partial phimosis. The foreskin does not go back entirely. It stops few centimeters before or halfway. It hurts too. I am not sure why I cannot maintain the erection and ejaculate, as when I masturbate, both things work fine. I am stressed and anxious. Do I have a venous leak problem causing erectile dysfunction? Please let me know which test I need to do.
Hi,
Welcome to icliniq.com.
It does not seem you have a venous leak, as your erection and ejaculation are good during masturbation. However, in the case of a venous leak, it will affect even during masturbation. The most probable reason for your problem can be partial phimosis, as, during intercourse, you will be subconsciously worried about the pain due to pulling back of prepuce (foreskin). This can cause detumescence of the penis and delayed ejaculation too. If you doubt penile blood flow or venous leak, the best Investigation is a Doppler ultrasound scan of the penis. If your phimosis has been for a long duration, you may need circumcision surgery. I hope this clarifies your doubt.
Patient's Query
Hi doctor,
Thanks for the reply.
I do not get the morning erections daily, but when I get it, it seems firm and stays erect for few minutes, I guess. Once I took Cialis, and it lasted longer, can I safely assume that I do not have a venous leak? What causes erectile dysfunction or soft erections?
Hi,
Welcome back to icliniq.com.
Usually, daily in the morning, a fully rigid erection does not happen. A Doppler scan can only make confirmation of venous leak of the penis. But your symptoms suggest it is less likely. As explained earlier, since your erection is normal during masturbation, some apprehension during a physical relationship is causing a soft erection. The possible cause in your case can be discomfort due to phimosis which is preventing full erection. Thanks.
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