OBJECTIVE CRITERIA IN THE LONG-TERM EVALUATION OF PENILE VENOUS SURGERY

Caverno-venous leakage is a frequent cause of impotence and, since ven ous network resection gives poor results, a study was performed to eva luate the prognostic factors of this surgical procedure. A total of 23 patients underwent surgery for caverno-venous leakage. With a minimum followup of 1 year, 12 patients had normal erections for sexual inter course. No significant difference was observed in patient age or maint enance flow rates between the responders and nonresponders. Objective quantification of the percentage of smooth muscle cells using computer ized image analysis after immunohistochemical staining (desmin antides min) for smooth muscle cells on cavernous biopsies performed during th e operation allowed us to differentiate significantly between the 2 gr oups. All responders had greater than 29% smooth muscle cells. Biopsy of the cavernous body with quantification of the different intracavern ous structures seems to be a prognostic factor in selecting impotent p atients for vascular reconstruction.