[Surgery for venocavernous impotence: what indications and techniques in 24 cases?]

The efficiency and even the usefulness of the venous reconstructive surgery are presently debated. 24 carefully selected cases of venocavernous impotence (VCI) have been operated on using: a. an extensive venous ligation, b. a pericavernoplasty, c. a cavernoplasty. After a median follow-up of 15 months, the erectile post-operative rigidity has been sufficient in only 8 cases (33%) spontaneously. In 7 cases (29%), a sufficient rigidity has been obtained only after intracavernous injection of drugs. No improvement has been noted in 9 cases (38%). The best results have been noted for VCI by rigidity obtention anomaly, without severe arterial or tissue lesions, or associated to La Peyronie's disease. The association venous ligation+pericavernoplasty+cavernoplasty, whatever the techniques appears hydraulically as an efficient solution for some selected VCI. In spite of the imprecisions of both definition and diagnostic criteria of VCI, a reduced number, still difficult to recognize, may be cured by venous surgery. Thus, the lack of reliability of this surgery seems to result more from an insufficiency of both its indications and its techniques than to a real usefulness.