SURGICAL-TREATMENT OF PENILE VENOOCCLUSIVE DYSFUNCTION - IS IT JUSTIFIED

Objectives. Veno-occlusive dysfunction is a commonly diagnosed cause o f impotence, Surgical removal of the intermediate (deep dorsal vein an d its tributaries) venous system of the penis has been advocated as an effective treatment but recurrence of the dysfunction is common after a few months. We studied prospectively the first 100 cases of veno-oc clusive dysfunction undergoing surgical treatment at our institutions. Methods. One hundred consecutive patients undergoing penile venous li gation surgery were evaluated, All patients had a comprehensive workup prior to therapy. Surgery involved excision of the intermediate venou s drainage. Short-term results were investigated by personal interview , and long-term outcome was determined by separate telephone interview of patients and their partners when available. Results. Short-term su ccess (3 months) was 62%, and long-term success (45 months) was 31%. H istorical factors, preoperative testing results, and histologic assess ment of the surgical specimens were not found to be helpful in predict ing outcome. Conclusions. Despite the mediocre long-term results of th e surgical procedure and lack of preoperative predictive factors, we b elieve that venous leak surgery could be offered to well-selected pati ents in whom the only other available alternative would be a prostheti c device.