I'm going to start 2 threads both related to post RP(and maybe post other PC treatments) sexuality. This is the 1st thread:
So whats up with venous leakage? Why does it happen?
Now I understand somethings about
nerve damage in nerve( or non-nerve) sparring RP surgery(NSRP vs NNSRP?). The nerves are either cut on purpose or by accident, or are often traumatized even if not cut. So often even with NSS, the nerves shut down for a few months or a year or more until adequate healing takes place, if it ever does heal.
If I understand correctly, more or less, the nerves signal the production of, OR directly release Nitric Oxide(NO?) in the cavernosa(going by memory here). The NO stimulates another substance(cGMP) that causes vessels(arteries) to dilate. When they dilate enough and swell enough, they pinch off some veins( peripheral sinusoids) which keeps the blood from running out as fast as it is flowing in, so things swell up in a useful fashion.
We produce an enzyme( I guess enzyme) PDE5 that breaks down this substance(cGMP) that causes smooth muscle relaxation/arterial dilation. Viagra etc inhibits this enzyme, leading to more cGMP, leading to a stronger erection, if the ED is not caused by an unrelated situation, like artery damage or something else besides not enough NO or the relaxing substance produced in response to NO.
So, pre-surgery, a pill would get me a pretty darn good erection, apparently with good dilation and good venous constriction, plenty enough to get the job done, and produce a pleasurable orgasm during penetration. Laying down seemed to make no difference, which was nice.
Enter my URO surgeon and my RRP. Assume the nerves were flat out cut and they are all gone. So no NO= no cGMP = zero erection with or without pills. It does no good to inhibit the enzyme which breaks down cGMP if there is no cGMP for it to break down, because there is no NO to produce the cGMP(AKA magic inflating substance)
Now I inject Trimix. I get a fair response, while some others get a pretty darned good response. But for me(and for some of the great responders), my fair response is strictly while standing straight up. If I lay down I go down to about
a 1 or 2, assuming zero before injection and 5 pushing 6 while standing with a 10 if I could get fully rigid, which I don't.
I am told this is venous leakage(VL). Why do I have this leak? I did not have VL with either a spontaneous or PDE5I drug before surgery. So I understand that if the nerves are cut, then there is no NO/cGMP. OK. But once I am erect, why aren't these veins crimped off enough to keep me erect when I lay down? I had thought maybe I did not have a good enough cardiac output to keep things going once I lowered the level of my heart relative to Mr. Flacid, but there was no trouble with this before surgery, and nothing has changed with my heart or fitness level.
I can keep things going with a VERY tight ring, but that amount of restriction seems like it would be way above what my body provided pre-op. Why so much tension required?
I can do OK laying down with no injections and a VED with either 2 rings or maybe a very tight single. But that raises another question: Using the VED, when I pump enough blood into the old boy for a rock hard erection, why doesn't that blood that is drawn in compress the veins and peripheral sinusoids like supposedly happens with a natural erection? Instead, remove the pump (with no rings) and it is instant deflation.
Enough of all that theory, I came here to get info. What exactly causes this VL that an erect member does not solve by compressing veins? Was something damaged besides the erection nerves? What is the best way to deal with it? Does it ever get any better or is it a lifetime deal?
Or is it as I am starting to suspect: the flow of NO through the nerves not only stimulates cGMP which relaxes and dilates, but also stimulates some other substance that simultaneously constricts veins? Or maybe the cGMP has opposite effect on arteries and veins? Thus dilating arteries with an injection does nothing for those veins that need restricting?
Hopefully some of you guys can educate me on the finer points and technicalities of VL and what to do about
it, if anything.
Post Edited (BillyBob@388) : 10/2/2014 7:58:35 PM (GMT-6)