Push for more vascular imaging

1.	Interventional radiology route
•	Find an IR who does cavernosography or penile venous embolization.
•	Ask specifically for spongiosal drainage mapping (bulbar and perineal venous outflow).
•	These people think in terms of plumbing — which is what you need, since the issue looks more vascular than neural.
2.	High-end imaging
•	If you can, push for dedicated small-field MRI of the perineum/penile base to look at:

• trabecular scarring, • fibrosis from prior trauma, • vessel narrowing or compression. • This might have to be done outside the standard urology channel (some radiology centers will do custom protocols if you ask).