Penile vein dissection: A study of its long-term efficacy in impotence

In recent years, venous leakage has been recognized as an important cause of erectile impotence. Dynamic cavernosography, a diagnostic test combining a cine-tape cavernosogram and intracavernous pressure measurement at three different infusion rates, was used to identify 49 patients with impotence caused by excessive venous drainage during erection. The patients underwent an operation to ligate some of the venous outflow, channels in the penis and were followed up between 2 and 52 (mean, 15.5) months afterward. Of the 49 patients, 35 initially had no erection at any infusion rate; 18/35 showed an improvement in erection at follow-up. The remaining 14 patients initially achieved partial erection at infusion rates of 120 or 180 ml/min; of these, 7/14 reported an improvement in erection at follow-up. Of the patients with no erection at any infusion rate, 56% showed a significant improvement at the time of follow-up.