ABSTRACT
From January 1990 to December 1991, 31 patients with venogenic erectile dysfunction [incompetent penile deep venous system] had been treated surgically by ligation of the superficial and deep venous systems of the penis by an inguinoscrotal approach which is the standard technique in all cases. The patients' ages ranged from 28 to 57 years [mean 44.7 +/- 3.4]. The duration of erectile failure ranged between 1 and 6 years. The main patient's complaint was failure to maintain erections. All patients had been investigated for blood sugar, renal and liver function tests as well as serum testosterone and prolactin. Evaluation of arterial penile vasculature and penile brachial index was done by Doppler studies. The diagnosis of venogenic incompetence had been confirmed by erectile cavernosography and cavernosometry. The postoperative follow up periods of the patients ranged between 6 and 18 months [mean 11 +/- 2.3]. Sufficient persistent improvement to permit unaided sexual intercourse for more than 18 months was achieved in 19 patients [61.3%]. Sufficient temporary improvement for 8 months or less was achieved in 6 patients [19.35%]. Six [19.35%] out of 31 patients continued to have the same preoperative erectile condition. It is recommended that the procedure in selected cases is simple, safe and gives relatively good success [80.65%] with minimal complications. For practical purposes, it is believed that venous surgery can be recommended as an acceptable alternative to a penile prosthesis in young patients with veno-occlusive dysfunction and adequate arterial function. However, longer periods of follow up are required for proper evaluation of the technique