How to interpret the Doppler results?

[Mezz123]

For some context, I am 25 and have been dealing with ED for about 2 years. Been taking 10mg cialis daily for a while now after starting with 2.5mg then 5mg. It's not always great but I also get anxious about sex sometimes, though my girlfriend is very supportive and understanding.

Yesterday I was diagnosed with a minor venous leak as the doppler showed a PSV of 21.6cm/s and a EDV of 15.16cm/s. I was only injected with 2 micrograms of Caverject (Alprostadil) and I know the typical dose is 10 or 20. The doctor left the room after injecting me, and came back about 20 minutes later. During that time my erection fluctuated, but once he was back it was pretty much dead and same thing during the test. He said that is not an issue and should be enough to diagnose a venous leak.

I had another doppler done 2 years ago with someone else. The reading then was 62cm/s PSV and 3.2cm/s EDV. I was also not erect during this test and this urologist also said it does not affect the results.

I did some reading and saw that the test is not reliable when not rigid enough and when PSV values are below 35cm/s. So, I am not sure who to trust. I know it doesn't change treatment, and the doctor just gave me some other meds to try, but it still makes me anxious to think it's a venous leak that could get worse (though the doctor said it likely wouldn't until I get much older).

Also, this doctor did not check any bloodwork. The last urologist said my testosterone was low for my age, but clomid only made things worse from my experience even though testosterone was higher. I do find it weird this doctor didn't do bloodwork and just went based off of what I said my bloodwork results were previously.

I'm not really sure what to believe now. For some more context, these are the notes from the doctor after the exam:

"Under sterile conditions, 0.1 mL of alprostadil 20 mcg/mL (NDC 51552-0498-02) from sample medication provided by Miller's pharmacy was injected into the right corpora without any difficulty. Erectile function and penile nerve conduction study was then performed. 50% erection was seen, fifteen minutes after injection. 30% erection was seen, thirty minutes after injection. Detumescence was seen at 45 minutes. Penile nerve appeared to be intact. Right cavernosa diameter measured: 1.57 mm Left cavernosa diameter measured: 2.03 mm. After this was done, a penile Doppler duplex scan was then performed 30 minutes after injection therapy using the 8.0 Mhz probe. Duplex scan was performed using B-mode/gray scale imaging and doppler spectral analysis and color flow. Documented arterial blood inflow and venous outflow could be seen. Waveform was visualized.

Peak systolic velocity: 21.6 cm per second End-diastolic velocity: 5.16 cm per second Resistive index: 0.76"

Any advice or input is appreciated!