[Venous leakage impotence: anatomical and physiological considerations upon gravity cavernosometry and...

We performed gravity cavernosometry and radio-fluoro-graphic cavernosography with pharmacological intracavernous injection in 15 patients with erectile dysfunction. On the basis of cavernosographyc findings, in the 15 patients leak sites visualized included deep dorsal vein in all 15 patients leak sites visualized included deep dorsal vein in all 15 patients (100%), cavernous veins in 7 (46,6%), glans in 4 (26,6%) and corpus spongiosum in 3 (20%). Aberrant veins documented in 4 patients (26,6%): communicating with the saphenous vein in 2 (13,3%), with scrotal veins and femoral vein in 1 (6,6%). Deep dorsal vein leakage as the only venous site was find in 2 patients (13.3%), 9 (60%) had leakage through 2 venous sites, 3 (20%) had leakage through 3 venous sites and 1 (6,6%) had leakage through 4 venous sites. Correlations among hemodynamic and radiographic observations allowed the identification of 2 types of cavernosometric findings. While type I developed an high intracavernous pressure during gravity infusion, an high intracavernous pressure was not observed in type 2. The FCG by the digital radio-fluoro-graphic digital system permit the possibility of sottraction and rielaboration of images and reduces examination and radiation time. The gravity FCM is simple, not expensive and respect the physiological intracavernous pressure.