title: Penile veins play a pivotal role in erection: the haemodynamic evidence.
abstract: Although penile venous surgery has almost been abandoned and the venous factor eliminated as a contributing factor to erectile dysfunction, new concepts of erection-related veins has recently been described and reported in literature. We sought to conduct a haemodynamic study on human cadavers in order to elucidate to what extent penile veins act in erection, and to explore the possible role of erection-related veins as an important contributor to impotence. From November 2002 to December 2003, seven fresh human cadavers of men who had no sexual activity for at least 6 months prior to death, and in whom the penis was intact were used for this study. Infusion cavernosometry was carried out with an induction flow of 150 mL/min before and after the erection-related veins were removed. A rigid erection was attained in all subjects, lasting significantly longer (p = 0.043) after removal of erection-related veins. Similarly, there were significant differences in the maintenance flow (p = 0.043), T(max) (p = 0.043), V(max) (p = 0.043), and pressure loss (p = 0.043). In cadaveric penises, a rigid erection could be maintained in spite of the fact that the low flow rate of 21 mL/min is much lower than the average arterial perfusion rate observed in cases of arterial insufficiency. We therefore concluded that penile veins may play a significant role in attaining sufficient erection, and further research is required to study this possible clinical implication.
authors.affiliation: Microsurgical Potency Reconstruction and Research Center, Taiwan Adventist Hospital, 424 Pa-Te Road, Sec. 2, Taipei, Taiwan. glhsu@tmu.edu.tw
authors.forename: Cheng-Hsing
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Chii-Jye
authors.initials: CJ
authors.lastname: Wang
authors.forename: Geng-Long
authors.initials: GL
authors.lastname: Hsu
authors.forename: Shyh-Chyan
authors.initials: SC
authors.lastname: Chen
authors.forename: Pei-Ying
authors.initials: PY
authors.lastname: Ling
authors.forename: Tsu
authors.initials: T
authors.lastname: Wang
authors.forename: Tsorng-Harn
authors.initials: TH
authors.lastname: Fong
authors.forename: Guo-Fang
authors.initials: GF
authors.lastname: Tseng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D007172:Erectile Dysfunction / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology*; D010413:Penis / Q000098:blood supply*; D014680:Veins / Q000502:physiology / Q000601:surgery