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Selective penile venography: anatomical and hemodynamic observations.
1Department of Radiology, University of California, San Diego.
The Journal of Urology
|July 1, 1988
Summary
Penile venography offers clearer insights into penile venous anatomy and hemodynamics than cavernosography. This study details key anatomical findings and their implications for treating venous abnormalities in impotent patients.
Area of Science:
- Radiology
- Vascular Anatomy
- Urology
Background:
- Cavernosography has limitations in demonstrating penile venous anatomy.
- Understanding penile venous hemodynamics is crucial for treating erectile dysfunction related to venous causes.
Purpose of the Study:
- To elucidate the detailed penile venous anatomy and hemodynamics using selective deep venography.
- To identify key anatomical landmarks for transcatheter venous ablation procedures.
Main Methods:
- Review of 17 selective deep venographic studies in 14 patients undergoing transcatheter venous ablation.
- Ancillary radiography of the glans and superficial dorsal venography were performed.
Main Results:
- Penile venography provided superior visualization of penile venous anatomy compared to cavernosography.
- Crural perforators visualized emptying into medial internal pudendal veins; internal pudendal vein flow is potentially bidirectional.
- The pre-prostatic plexus acts as a conduit for accessing the deep penile venous system; contrast reflux into erectile bodies observed during Valsalva maneuver in impotent patients.
- Minimal direct communication between deep and superficial venous systems; glans primarily drains via the deep dorsal penile vein.
Conclusions:
- Selective deep venography is an effective method for detailed penile venous anatomy assessment.
- New anatomical insights support transcatheter venous ablation for venous-related erectile dysfunction.
- Findings clarify venous drainage pathways and potential targets for interventional procedures.