Embolization of the deep dorsal vein for the treatment of erectile impotence due to veno-occlusive dysfunction

Purpose: We evaluate the effectiveness of deep dorsal vein embolization for the treatment of venous impotence. Materials and Methods: A total of 32 impotent patients with veno-occlusive dysfunction underwent deep dorsal vein embolization. The condition was susp ected based on findings of penile Doppler ultrasonography and cavernosometr y. The diagnosis was confirmed with pharmacocavernosography that appeared t o delineate venous leakage. During the procedure we isolated and cannulated the deep dorsal vein through a small dorsal penile incision with the patie nt under local anesthesia. We used a mixture of the tissue glue, N-butyl cy anoacrylate, and lipodol for embolization, with a total volume of 5 ml. inj ected antegrade into the previously catheterized dorsal vein under fluorosc opic control. As soon as we observed the occluded veins we performed repeat pharmacocavernosography. At 3-month followup patients were reassessed with history and cavernosometry. Followup ranged from 12 to 36 months (median 2 5). Results: Of 32 patients 22 (68.7%) regained sexual activity, which was conf irmed by cavernosometry. The remaining 10 patients (31.3%) experienced litt le if any clinical response, which correlated with cavernosometry. There we re no significant side effects. Conclusions: Deep dorsal vein embolization for venogenic impotence is simpl e, effective and safe, and appears to be cost-effective. The results obtain ed in this limited number of patients are promising and justify trials in l arger groups.