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 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. From a psychiatric perspective, could depression or Venlafaxine fully explain these symptoms, or do you think I should pursue further evaluation with a urologist?