[Pharmacocavernosography: a worth-while examination in the evaluation of venogenic impotence]

From November 1988 till July 1989, a total of 78 patients consulted our OPD with a chief complaint of impotence. These patients underwent evaluation with pharmacocavernosography alone, or combined with color duplex sonography (Acuon 128). Sixty-three (80.8%) patients were found to have abnormal venous drainage which, in one case, was associated with peyronie's disease. Among these patients, the sites for the contrast medium in the venous drainage system from the penis were determined as follows: the preprostatic plexus for 53 (67.9%) patients, the proximal (cavernosal or crural) vein for 50 (64.1%) patients; the internal pudendal vein for 46 (58.9%) patients; the deep dorsal vein for 31 (39.7%) patients; the glans of the penis for 8 (10.3%) patients; the external pudendal vein for 8 (10.3%) patients and the corpus spongiosum for 3 (3.8%) patients. So the venous ligation for venogenic impotence had to include all these visible veins, especially the proximal vein. Among the 52 patients who once had received duplex scanning, 43 (82.7%) patients had abnormal venous drainage. So the duplex sonography did not seem to influence the population of venous leakage and 12 patients exhibited moderate to severe degree of arteriogenic insufficiency. Pharmacocavernosography in these patients was less valuable. No severe complications, such as priapism, were found. We found pharmacocavernosography to be a simple, practical and useful tool for evaluating patients suspected to have venogenic impotence. It can determine the sites of venous leakage (the key information for planning venous ligation) and provides good morphological information in the study of cavernous bodies. But it was not reliable in the evaluation of the severity of venous leakage.