Preliminary report--combined surgical and radiological penile vein occlusion for the management of impotence caused by venous-sinusoidal incompetence.
OBJECTIVE
To combine surgical and radiological penile vein occlusion therapy in the treatment of patients with venogenic impotence, to try to improve on the results of either treatment used separately.


METHODS
Fourteen patients, with a mean age of 46 years (range 25-71), with pure venous-sinusoidal impotence were treated by surgical ligation of accessible veins and embolization of surgically inaccessible veins. The preliminary results over a follow-up period of at least 8 months are reported for each patient.


RESULTS
Venous embolization was considered complete in 11 patients. Overall, 13 had improved erectile function. Post-operatively, eight patients developed spontaneous erections and four (aged < 40 years) have maintained this for 8-24 months.


CONCLUSIONS
Combined surgery and radiology treats the end result of the failure of the sinusoidal smooth muscle to relax. Although some patients, the majority of whom are young (aged < 40 years), will achieve short-term benefit, all individuals need to be fully counselled with regard to the likelihood of long-term benefit before undergoing this invasive method of treatment.
Fowlis
G A
GA
Department of Surgery, Hammersmith Hospital, London, UK.
Sidhu
P S
PS
Jager
H R
HR
Agarwal
S
S
Jackson
J E
JE
Zafar
F
F
Williams
G
G
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D018783:Impotence, Vasculogenic / Q000209:etiology / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010413:Penis / Q000098:blood supply* / Q000601:surgery; D014680:Veins