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Venous surgery for impotence.

R W Lewis1

  • 1Mayo Medical School, Rochester, Minnesota.

The Urologic Clinics of North America
|February 1, 1988
PubMed
Summary
This summary is machine-generated.

Venous surgery for erectile dysfunction (ED) shows variable results. Eliminating superficial venous drainage improves outcomes in select patients, but complex cases have high failure rates.

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Area of Science:

  • Urology
  • Vascular Surgery
  • Andrology

Background:

  • Erectile dysfunction (ED) can stem from veno-occlusive dysfunction.
  • Normal penile venous drainage involves deep dorsal, cavernous, and crural veins.

Purpose of the Study:

  • To evaluate the efficacy of venous surgery for ED.
  • To identify patient subgroups likely to benefit from specific surgical interventions.

Main Methods:

  • Cavernosography to assess venous drainage patterns.
  • Intracavernous vasoactive agent injections to differentiate venous leakage.
  • Surgical ligation or elimination of specific venous outflow tracts.

Main Results:

  • Patients with superficial venous drainage persisting after vasoactive agent injection showed good surgical outcomes upon elimination.

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  • Surgical attempts to ligate deep dorsal penile or crural veins yielded less successful results.
  • Postoperative intracavernous injections often restored erectile function in surgical failures.

    • Conclusions:

    • Venous surgery for ED is effective in a specific subset of patients with superficial venous drainage.
    • Complex venous leakage, arterial insufficiency, or neurologic factors contribute to surgical failure.
    • Deep dorsal vein arterialization is indicated for combined arterial and venogenic ED.