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A case report of right cardiac ventricle perforation by uncontrolled embolization coil inserted for treating penile
Geng-Long Hsu1, Yi-Kai Chang2, I-Ni Chiang2
1Microsurgical Potency Reconstruction and Research Center, Hsu's Andrology, Shu-Tien Urology Ophthalmology Clinic and Chung Shan Hospital, Taipei, Taiwan.
Insights
Coil embolization (CE) for penile veno-occlusive dysfunction (VOD) is unreliable. Uncontrolled coils migrated, causing serious complications and no sustainable improvement in patients.
Area of Science:
- Urology
- Interventional Radiology
Background:
- Penile veno-occlusive dysfunction (VOD) is a cause of erectile dysfunction.
- Coil embolization (CE) is a proposed treatment for VOD.
Observation:
- Four men with refractory impotence underwent six CE procedures.
- Uncontrolled coils migrated from penile veins to the deep dorsal veins, periprostatic plexus, iliac vein, pulmonary arteries, and right ventricle.
- One patient experienced coil perforation of the right ventricle and diaphragm.
Findings:
- CE for VOD resulted in significant complications due to uncontrolled coil migration.
- No sustainable improvement in erectile function was observed post-CE.
- The safety and efficacy of CE for VOD are questionable.
Implications:
- Current CE techniques for VOD carry substantial risks.
- Alternative or refined treatment strategies for VOD are needed.
- Further research is required to evaluate the long-term outcomes and safety of CE in VOD treatment.
Abstract:
Coil embolization (CE) is believed effective-safe for treating penile veno-occlusive dysfunction (VOD). From 2012 to 2016, refractory impotence prompted four men to seek further treatment, although they underwent six CEs elsewhere. Uncontrolled coils scattered along penile drainage veins including the deep dorsal veins (n = 3), periprostatic plexus (n = 1), iliac vein (n = 1), right pulmonary artery (n = 2), left pulmonary artery (n = 1), and right ventricle (n = 1). The last one occurred in a 40-year-old house builder, and the coil perforated the right ventricle wall and diaphragm 18 months later. Given no sustainable improvement, CE's safety and efficacy are unreliable for treating patients with VOD.
