title: Diagnosis and treatment of venous leakage: a curable cause of impotence.
abstract: Sixteen of 149 patients complaining of impotence of a non-neurogenic or endocrine aetiology and with a penile brachial index of greater than 0.7 failed to achieve an erection following intracavernosal injection of 30 mg papaverine and 1 mg phentolamine. All 16 were shown to have a significant venous leak using digital subtraction cavernosography. Nine of the 13 so far operated upon have had a full return of potency. Repeat cavernosography in three failures showed persistent leakage into crural veins in two and non-ligated superficial veins in one. Impotent men with a normal penile brachial index who fail to respond to papaverine and phentolamine have a venous leak, a curable cause of impotence. Surgical access should allow ligation of all identified leaking veins.
authors.affiliation: Department of Surgery, Hammersmith Hospital, London.
authors.forename: G
authors.initials: G
authors.lastname: Williams
authors.forename: M J
authors.initials: MJ
authors.lastname: Mulcahy
authors.forename: G
authors.initials: G
authors.lastname: Hartnell
authors.forename: E
authors.initials: E
authors.lastname: Kiely
mesh_terms: D000328:Adult; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010208:Papaverine; D010410:Penile Erection / Q000187:drug effects; D010413:Penis / Q000098:blood supply* / Q000000981:diagnostic imaging; D010646:Phentolamine; D010690:Phlebography; D012039:Regional Blood Flow; D013382:Subtraction Technique; D014680:Veins / Q000601:surgery
chemical_list: D010208:Papaverine; D010646:Phentolamine