Venous surgery in erectile dysfunction.
According to the physiopathological process beyond it, veno-occlusive dysfunction (VOD) may be classified in organic or functional VOD. The former is caused by lack of control of smooth muscle relaxation, while the later is related with morphological alterations of the corporeal tissue. The differential diagnosis of those two types is fundamental when venous surgery is to be discussed. Functional VOD may be treated with sex therapy, while in organic VOD, surgical treatment may be considered. The experience with venous surgery for impotence at the H. Ellis Institute was not encouraging. Although a few patients were cured, the long-term follow-up showed that only 9 out of 57 patients were able to have a normal sexual life. New diagnostic tools, as well as a better understanding of the erectile mechanism, may lead to a better selection of cases with an improvement of the results in the future. Today, venous surgery remains as an option to patients with organic VOD, who are willing to accept a 45% probability of improvement for a few months, having been informed about all the other options in the treatment of erectile disorders.
Puech-Leão
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Department of Vascular Surgery, University of Saõ Paulo School of Medicine, Brazil.
D007172:Erectile Dysfunction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008297:Male; D010410:Penile Erection; D011182:Postoperative Care; D011183:Postoperative Complications; D014652:Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods