[Embedding of the deep dorsal vein into the duplication of the tunica albuginea--a new method for the surgical treatment of venous insufficiency of the corpora cavernosa penis]

Abstract

The methods to block the venous drainage of the spongy bodies (ligation, arterialization and embolization of the venous system in the penis) used in the treatment of vascular erectile impotence lead to spongy tissue sclerosis. The pathogenetic unfoundedness of the above methods prompted the authors to develop better methods for treating the venous insufficiency of the spongy bodies. Nineteen patients with erectile impotence were examined by using drug (papaverin), induced erection, dynamic spongiography, cavernography, and spongiobiopsy. The examination provided a classification of venous insufficiency in the spongy bodies, which included 3 types of the disease: distal, proximal, and mixed. For the treatment of the distal pattern, a new surgical method was developed, namely, immersion of the deep dorsal vein of the penis into the duplication of the tunica albuginea in the spongy bodies. The method partially blocks the venous drainage only in the erected penis, thus avoiding persistent venous hypertension in the erected penis, thus avoiding persistent venous hypertension in the spongy bodies. Five patients were operated on. The follow-up of 3 months to 1 year showed an improvement of penis erectility. Lower venous drainage in the spongy bodies was evidenced by Doppler sonography and perfusion artificial erection. Thus, the proposed operation is an effective tool to correct venous drainage in the spongy bodies.