Venous surgery in erectile dysfunction: a critical report on 116 patients.

From June, 1985, to December, 1987, we operated on 116 impotent patients suffering from venous incompetence of the cavernous bodies. A total of 115 patients underwent ligation of the deep dorsal vein of the penis. After a mean follow-up of 12.9 months, 67 patients (58.3%) were still able to obtain satisfactory erections. In 39 cases (33.9%), however, adjuvant corpus cavernosum autoinjection therapy was necessary. Eleven patients were submitted to spongiosolysis after ligation of the deep dorsal penile vein because of a distal venous leakage, consisting of venous shunts between the corpora cavernosa and the corpus spongiosum. After a mean follow-up of 14.2 months, 9 patients (81.8%) reported excellent penile rigidity; 5 of these patients, however, needed corpus cavernosum autoinjection therapy to maintain erectile function. One patient with ectopic veins emerging from the right crus of the penis was operated on successfully from a perineal approach. Serious complications did not occur in any of the patients. Despite the recurrence rate of 13 percent, venous surgery is an effective treatment for most patients concerned and offers a more physiologic erectile function than can be achieved by implantation of a penile prosthesis.