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Experience with penile venous surgery
H G Motiwala1, D D Patel, S P Joshi
1Department of Urology, Institute of Post Graduate Studies and Research, B.J. Medical College, Civil Hospital, Ahmedabad, India.
Urologia Internationalis
|January 1, 1993
Summary
Penile venous surgery effectively treats venogenic impotence caused by corporovenous leak (CVL) in selected patients. While surgical outcomes vary, it offers a potential solution for erectile dysfunction stemming from venous leakage.
Area of Science:
- Urology
- Andrology
- Vascular Surgery
Background:
- Erectile dysfunction (ED) is a common complaint, with venogenic impotence due to corporovenous leak (CVL) being a significant subtype.
- Patients with CVL often show poor response to initial medical treatments like intracavernosal papaverine.
Purpose of the Study:
- To evaluate the efficacy of penile venous surgery in treating venogenic impotence caused by CVL.
- To identify factors influencing surgical outcomes in patients with CVL.
Main Methods:
- Dynamic pharmacocavernosometry and cavernosography were used to diagnose CVL in 37 patients with erectile dysfunction.
- Penile duplex Doppler ultrasound assessed for concomitant arterial causes.
- 24 patients underwent various penile venous surgical procedures, including ligation and excision of affected veins.
Main Results:
- Corporovenous leak was identified as the primary cause of impotence in 37 out of 141 patients.
- Surgical intervention yielded excellent results in 11 patients, improvement in 6, and failure in 7.
- The deep dorsal vein was the most common site of CVL, followed by the cavernous and crural veins.
Conclusions:
- Penile venous surgery can be effective for selected patients with CVL-related erectile dysfunction.
- Factors such as age, arteriogenic causes, extent of venous leak, and recurrent leakage can limit surgical success.