Long-term results of deep dorsal penile vein transsection in venous impotence

29 individuals with venous impotence underwent transsection of the deep dorsal penile vein, of the superficial and ectopic veins, if any. 19 patients responded initially with either spontaneous erections or increased sensitivity of the cavernous bodies to intracorporeal papaverine. 1 patient developed postoperative priapism. The majority of patients who failed to respond had major leakage into the cavernous veins or abnormal connections between the spongious and cavernous bodies. An intraoperative decrease of flow rates to induce and maintain erection was found to be indicative for response. 10 individuals developed secondary erectile dysfunction 4-24 months after the initial response. A more extensive surgical approach should be considered to improve long-term success rates.