J Korean Androl Soc.  1994 Jan;12(1):25-30.

Long-Term Follow up of Patients with Penile Vein Ligation for Cavernosal Venous Leakage

• Suh JK
• Mun KH
• Jang TG
• Kim YS
• Park TC

Abstract

Recent advances in clinical and basic research have led to the identification of cavernosal venous leakage as a cause of erectile dysfunction. Although this entity is diagnosed readily by various methods, its surgical management by vascular reconstructive procedures has been met with different degress of success. We report long term follow-up of a group of patients and who have undergone penile vein ligation surgery(modified Lue's procedure) for cavernosal venous leakage. Thirteen patients(mean age:32.2 years, range:22-50 years) were extensively evaluated preoperatively and all received 20 microgram of prostaglandin E1 at the time of cavernosometry and cavernosography to identify their cavernosal venous leakage. At follow-up from 3 to 6 months postoperatively, 5 patients(39%) had total return of erectile function sufficient for satisfactory sexual life(grade 1), 5 patients(39%) had improved erectile function but required intracavernosal injection of a vasoactive drug(Grade 2), and 3 patients(23%) did not show any erectile function(Grade 3). At long-term follow-up from 32 to 43 months, 2(15%) of the patients with Grade 1 function still maintained satisfactory sexual life, whereas 3 patients had moved down into Grade 2 or Grade 3. Three of the patients with Grade 2 function initially moved down into Grade 3. In analysis of prognostic factors for the postoperative outcome of vein ligation surgery, there was no significant difference in preoperative cavernosometric findings among the three groups. In contrast, preoperative cavernosography showed combined venous leakage through the crural vein in 5 of 7 patients with Grade 3 function, compared to the abscence of venous leakage through the crural vein in Grade 1 or 2. The results suggest that penile vein ligation surgery be applied more selectively in cases of cavernosal venous leakage, as the long-term success rate is low. The preoperative cavernosographic finding

MeSH Terms

Alprostadil
Erectile Dysfunction
Female
Follow-Up Studies*
Humans
Impotence, Vasculogenic
Ligation*
Male
Veins*
Alprostadil