title: Cavernous body reduction in four patients with erectile dysfunction due to insufficient venous occlusion and a deficit of elastic fibers in the tunica albuginea.
abstract: BACKGROUND
  The corpora cavernosa are cylindrical vessels containing fluid under pressure. Thus, if cavernous wall resistance decreases, the radius increases and internal pressure decreases (LaPlace's law). We reasoned that if we decrease the corpus cavernosum radius, by excising a strip from each tunica albuginea, intracavernous pressure would increase during erection.
  
  
  METHODS
  We treated with this procedure, four patients (mean age 41.5) with long-standing erectile dysfunction due to veno-occlusive dysfunction, non-responders to phosphodiesterase-5 inhibitors and intracavernous PGE1 injection.
  
  
  RESULTS
  Two months post-surgery, intracavernous PGE1 (40 mcg) induced a satisfactory erection in two patients and a 45% and 58% tumescence in the other two. PGE1 responders also responded to 100 mg sildenafil. After 100 mg sildenafil and 20 mg tadalafil, the two non-responders had erections that enabled penetration but were short lasting.
  
  
  CONCLUSIONS
  The procedure described could be more effective than cavernous revascularization operations. The results seem to confirm the mathematical assumptions.
authors.affiliation: Section of Urology, School of Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Iacono
authors.forename: Domenico
authors.initials: D
authors.lastname: Prezioso
authors.forename: Stefania
authors.initials: S
authors.lastname: Chierchia
authors.forename: Raffaele
authors.initials: R
authors.lastname: Galasso
authors.forename: Gennaro
authors.initials: G
authors.lastname: Iapicca
authors.forename: Mario
authors.initials: M
authors.lastname: Di Martino
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D004547:Elastic Tissue / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D018783:Impotence, Vasculogenic / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000098:blood supply / Q000601:surgery*; D011184:Postoperative Period