The impact of venous ligation on erectile dysfunction in young patients with an abnormal dorsal penile vein: Clinical outcomes of a novel surgical procedure.

INTRODUCTION

Erectile dysfunction (ED) is a significant issue that adversely affects the quality of life in young men. Venous leakage is a common etiologic factors of ED. This study aimed to evaluate the clinical efficacy and safety of venous ligation applied to incidentally detected dorsal penile vein anomalies during penoscrotal surgeries.

METHODS

The study included 32 young male patients who presented with ED and underwent surgery for penoscrotal pathology (e.g., varicocele, hydrocele, spermatocele), during which an isolated dorsal penile vein anomaly was concurrently ligated. Patients were assessed preoperatively and at three and six months postoperatively using the International Index of Erectile Function (IIEF-5). Postoperative erectile response, patient satisfaction, and the presence of complications were also evaluated.

RESULTS

The mean age was 33.1±5.4 years. The median operative time was 20 minutes (18-25), and the median followup duration was six months (6-9). The median IIEF-5 score increased from 18 (17-19) preoperatively to 21 (20-22) at three months and 22 (22-24) at six months (p1<0.001, p2<0.001, p3<0.001). Patient satisfaction improved significantly, with median satisfaction scores of 8 (8-9) at three months and 9 (8-10) at six months (p3<0.001). The need for PDE5i therapy decreased markedly, from 100% preoperatively to 56.2% at three months and 31.3% at six months (p1<0.001, p2<0.001, p3<0.001). No perioperative or postoperative complications were recorded.

CONCLUSIONS

Venous ligation applied to incidentally detected dorsal penile vein anomalies during penoscrotal surgeries represents an effective and reliable therapeutic option for young patients with ED.