[Leakage correction by resection of the deep dorsal penis vein. Assessment of results after 4 years of venous potency surgery].

Resection of the deep dorsal vein is accepted as a short-term working procedure to reestablish erection in patients suffering from venous leakage. After 4 years with a standardized diagnostic and surgical program for pathologic venous drainage, we are now able to describe the outcome of vein resection in 51 men, whom we have treated 1-4 years before follow-up examination. After a median follow-up of 20 months, long-lasting full erection can be reported in 28 men. Of the remaining 23 men, reestablished erectile function decreased within 1 year in 8, while the operation failed in 15. Whereas the site of pathologic venous drainage and preoperative maintenance flow rates do not influence surgical outcome, a moderate arterial cofactor has become obvious in a large proportion of the unsuccessfully treated cases. In 14 of these men, papaverine testing has now become positive, so that penile self-injection of the drug makes adequate sexual intercourse possible. All patients with a postoperative negative papaverine reaction again have all the signs of a persistent pathological venous drainage; only in 2 of these cases has an ectopic vein been successfully resected.