Pelvic venoablation with ethanol for the treatment of erectile dysfunctiondue to veno-occlusive dysfunction

Objectives. To perform pelvic venoablation with ethanol injection into the deep dorsal vein for the treatment of 10 patients with venogenic erectile d ysfunction. This procedure was easily performed without any selective embol ization technique. The efficacy and safety of this technique are discussed. Methods. A total of 10 patients with veno-occlusive dysfunction, severe eno ugh to make vaginal insertion impossible, underwent pelvic venoablation wit h ethanol. The mean patient age was 67.1 years. Under spinal anesthesia, af ter the venous leaks were identified by cavernosography, a 20-gauge flexibl e needle was inserted into the deep dorsal vein. The pelvic venogram obtain ed with deep dorsal venography was included in what was revealed by the ven ogram obtained with cavernosography. A mixture of absolute ethanol and cont rast medium (4:1) was used as a sclerosing agent. Under fluoroscopic contro l, the sclerosing agents were injected into the deep dorsal vein through a flexible needle. Success was defined as the ability to achieve vaginal inse rtion without the aid of any drugs, vasoactive injections, penile prosthesi s, or vacuum device. Results. The follow-up ranged from 25 to 37 months (mean 32.3). At the shor t-term follow-up visit (less than 6 months), 7 patients (70%) reported erec tions sufficient for vaginal insertion; at the long-term follow-up visit, 5 men (50%) reported sustained, sufficient potency and 5 (50%) reported pers istent erectile dysfunction. No serious complications occurred. Conclusions. Our pelvic venoablation technique using ethanol was effective, minimally invasive, and cost-effective. UROLOGY 58: 76-79, 2001. (C) 2001, Elsevier Science Inc.