Penile dorsal vein arterialization in managing venogenic impotence

Several surgical techniques have been applied for the treatment of venoocclusive dysfunction sufficient enough to create erectile dysfunction; however, long-term success rates have been dismal. Twenty-six patients (mean age, 41 years) with documented venogenic erectile dysfunction by dynamic pharmacocavernosometry and cavernosography, who had normal pelvic arteriograms, underwent deep dorsal vein arterialization. All patients preoperatively were nonresponders to injected intracavernosal vasoactive agents. These patients have been followed up for 18-52 months (mean, 37 months). Overall success rates show that eight patients (31%) are able to have unaided satisfactory intercourse and nine patients (35%) have become responders to intracavernosal vasoactive injection therapy. Postoperative complications were minimal, and no patient developed hypervascularization of the glans. Deep dorsal vein arterialization remains a viable treatment option for the properly selected, motivated, young patient who does not wish to pursue other treatment options for his venoocclusive dysfunction.