Hello Doctor, I have had persistent sexual function problems for the past 6 years, including difficulty getting and maintaining erections, reduced morning erections (about once a week), and reduced spontaneous arousal. Around the time my symptoms started, I had a minor accident. During an erection, I heard a "pop" sound followed by a sudden loss of erection. There was no pain, swelling, bruising, or deformity. A flaccid penile ultrasound was reported as normal. I also have depression and am currently taking Venlafaxine. I have consulted two urologists, and both felt my symptoms were mainly psychological. They did not recommend a dynamic penile Doppler, stating it would not change the treatment plan. My sexual function is still significantly different from before and is affecting my quality of life. Should I consult a urologist or a psychiatrist first? Would you recommend any further evaluation, including whether a dynamic penile Doppler is appropriate?