Venogenic impotence. Diagnosis, management, and results

Veno-occlusion has been clearly established as a necessary phase of the erectile cycle. Surgery directed at eliminating some of the draining veins has been performed since 1981 as a type of treatment for male erectile dysfunction. Abnormal venous drainage due to excessive pathologic venous outflow or congenital abnormalities is rare. Veno-occlusive dysfunction can be secondary to poor arterial inflow or decreased compliance of corporal sinus tissue. Cavernosometry and cavernosography reports describe an amazing consistency of ability to diagnose corporal veno-occlusive dysfunction. Yet, surgery directed at eliminating veins above the tunica albuginea give long-term improvement, including the ability to convert some patients to pharmacologic injection therapeutic treatment, in only 50-70% of the patients. Improved diagnostic techniques will further delineate a relative small group of patients who might benefit from current veno-occlusive dysfunction surgery. Despite this, a group of patients do benefit long-term from veno-occlusive dysfunction surgery.