title: Embolization of the periprostatic venous plexus for erectile dysfunction resulting from venous leakage.
abstract: OBJECTIVE
  To evaluate retrospectively the safety and efficacy of anterograde embolization of the periprostatic venous plexus (AEPV) via percutaneous access of the deep dorsal vein of the penis for erectile dysfunction (ED) resulting from veno-occlusive dysfunction (VOD).
  
  
  METHODS
  From September 2009 through December 2012, 18 patients with moderate to severe ED secondary to insufficiency of physiologic venous occlusion as diagnosed by color Doppler evaluation of the penis after direct pharmacologic stimulation were treated. Preliminary diagnoses were also confirmed with dynamic cavernosography. Selective AEPV was achieved using a combination of N-butyl cyanoacrylate and endovascular coils. Follow-up consisted of collecting International Index of Erectile Function questionnaire (IIEF-6) scores and repeated color Doppler evaluation.
  
  
  RESULTS
  Immediate technical success was achieved in 16 of 18 patients (88.8%). Follow-up data were obtained at a mean of 13.3 months ± 7.5. In 12 of the patients with technical success, the mean IIEF-6 score improved from 10.5 ± 5.2 to 20.6 ± 8.4 after the procedure (P = .0069). At 3-month short-term follow-up, clinical success defined by an end-diastolic velocity of < 5 cm/s on color Doppler was noted in 81% (13 of 16 patients). Of these 13 patients, 7 patients had continued erectile function at the end of follow-up, and the other 6 patients reported progressive diminishment in the benefit over time. No major complications and two minor complications were encountered.
  
  
  CONCLUSIONS
  AEPV for ED secondary to VOD is a safe alternative to surgical treatment that demonstrates promising short-term and midterm efficacy.
authors.affiliation: Department of Surgery, Radiology and Odontostomatology Sciences, Santa Maria della Misericordia University Hospital, University of Perugia, Sant'Andrea delle Fratte, Perugia, 06132; Radiology Department, ASL 1 Massa Carrara, Carrara. Electronic address: rebonatoalberto@gmail.com.
authors.forename: Alberto
authors.initials: A
authors.lastname: Rebonato
authors.affiliation: Radiology Department, ASL 1 Massa Carrara, Carrara.
authors.forename: Alessio
authors.initials: A
authors.lastname: Auci
authors.affiliation: Radiology Department, ASL 1 Massa Carrara, Carrara.
authors.forename: Franco
authors.initials: F
authors.lastname: Sanguinetti
authors.affiliation: Department of Surgery, Radiology and Odontostomatology Sciences, Santa Maria della Misericordia University Hospital, University of Perugia, Sant'Andrea delle Fratte, Perugia, 06132.
authors.forename: Daniele
authors.initials: D
authors.lastname: Maiettini
authors.affiliation: Radiology Department, St. Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "La Sapienza," Rome.
authors.forename: Michele
authors.initials: M
authors.lastname: Rossi
authors.affiliation: Department of Medicine and Health Sciences, Università del Molise, Contrada Tappino, Campobasso.
authors.forename: Luca
authors.initials: L
authors.lastname: Brunese
authors.affiliation: Department of Human Morphology, Insubria University Hospital, Varese, Italy.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
authors.affiliation: Radiology Department, ASL 1 Massa Carrara, Carrara.
authors.forename: Tito
authors.initials: T
authors.lastname: Torri
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D004659:Enbucrilate / Q000008:administration & dosage; D006801:Humans; D018783:Impotence, Vasculogenic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010413:Penis / Q000098:blood supply* / Q000503:physiopathology; D010690:Phlebography; D020127:Recovery of Function; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014680:Veins / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D004659:Enbucrilate