Deep dorsal vein arterialization in pure cavernoocclusive dysfunction

Purpose: We report our 4-year experience with deep dorsal vein arterializat ion at 3 years' for low-up in young patients with pure cavernoocclusive dys function as an alternative to penile prosthesis implantation. Materials and Methods: We performed a modified Furrow-Fisher operation (cir cumflex collaterals are preserved and the deep dorsal venous valves are not disrupted by a stipper) in 25 patients who did not have risk factors such as general arteriosclerosis, coronary heart disease, hypertension, hyperlip idemia and age (over 40 years). Patients with arterial disease diagnosed by Doppler examination were excluded from the study. Also, patients with abno rmal penile biothesiometric and electromyographic findings were not include d in the study. Beside the subjective and objective evaluation the efficacy of the operation was also assessed retrospectively in 18 patients by telep hone according to items 3 (ability to achieve an erection) and 4 (ability t o maintain an erection) of the 15-item International Index of Erectile Func tion (IIEF). Results: With a mean follow-up of 28 months (range 4-42) subjective and obj ective success rates were 80 and 72% at 1 year's 75 and 62.5% at 2 years', and 70 and 60% at 3 years' follow up. According to items 3 and 4 of the 15 item IIEF questionnaire the mean postoperative scores reached 1.55-3.44 and 1.33-3.27 for items 3 and 4, respectively (p < 0.01). Two patients (8%) sh owed signs of glans hypervascularization as a major complication and minor complications such as penile skin edema, subdermal hematoma, loss of penile skin sensation and early thrombosis of the anastomosis were found in a tot al of 8 patients (32%). Conclusions: Deep dorsal vein arterialization is a preferable choice in hig hly selected young patients as an alternative to penile prosthesis.n Copyri ght (C) 2000 S. Karger AG, Basel.