Is dorsale penile vein ligation (dpvl) still a treatment option in veno-occlusive dysfunction?

PURPOSE: To determine the long-term results of the DPVL for the treatment of venous impotence.

PATIENTS AND

METHODS

The long term results of DPVL in 134 patients were interviewed. The mean age was 39.2 (range 21-72). Power color doppler imaging, pharmacocavernography/dynamic cavernosometry were performed. Postoperatively, all the patients were controlled in the 6th month, first year and, if possible, once a year. The mean follow-up was 54.8 (14-76) months. Postoperative outcomes were classified into three groups: complete spontaneous erection (CR), response to pharmacotherapy (PR) or no satisfactory improvement (NR).

RESULTS

The short-term success in the 6th month according to above mentioned was 38.8%, 18.6% and 42.5%; and in the first year was 19.4%, 14.9% and 65.6% respectively. The result in 35 patients whose follow-up was at least 5 years (mean 67 months) was 11.4%, 14.3% and 74.3% respectively. Positive prognostic factors were preoperative age <40, duration of erectile dysfunction <2 years, non-smoker patients, non neurogenic disease and distal disease. With all these parameters present, long-term success (CR, PR) rose from 33.6% to 55.9% (P < 0.001).

CONCLUSIONS

Long-term success for unselected patients undergoing DPVL is disappointing; however, careful patient selection significantly improves long-term results.