PRELIMINARY-REPORT - COMBINED SURGICAL AND RADIOLOGICAL PENILE VEIN OCCLUSION FOR THE MANAGEMENT OF IMPOTENCE CAUSED BY VENOUS-SINUSOIDAL INCOMPETENCE

Objectives To combine surgical and radiological penile vein occlusion therapy in the treatment of patients with venogenic impotence, to try to improve on the results of either treatment used separately. Patient s and methods Fourteen patients, with a mean age of 46 years (range 25 -71), with pure venous-sinusoidal impotence were treated by surgical l igation of accessible veins and embolization of surgically inaccessibl e veins. The preliminary results over a followup period of at least 8 months are reported for each patient. Results Venous embolization was considered complete in 11 patients. Overall, 13 had improved erectile function. Post-operatively, eight patients developed spontaneous erect ions and four (aged < 40 years) have maintained this for 8-24 months. Conclusion Combined surgery and radiology treats the end result of the failure of the sinusoidal smooth muscle to relax. Although some patie nts, the majority of whom are young (aged < 40 years), will achieve sh ort-term benefit, all individuals need to be fully counselled with reg ard to the likelihood of long-term benefit before undergoing this inva sive method of treatment.