Peyronie's disease with venogenic impotence: A report of 3 cases / 대한비뇨기과학회지

We report our experience with unusual cases of Peyronie`s disease concurrent with venogenic impotence. Three patients have suffered from distressful sexual life including painful erection. penile curvature and poor penile tumescence. Following multidisciplinary work-ups for impotence in those patients. it proved be that they had venogenic impotence as well as Peyronie`s disease. Since intrapenile triamcinolone injection therapy did not improve their symptoms. a single-staged, surgical procedure was performed to resolve problems with Peyronie`s disease and venogenic impotence at a time in each patient It was proceeded with ligation of penile vein. excision of the fibrous plaque and replacement with dermal graft respectively. In a patient. additional Nesbit`s procedure was required to correct sustained penile curvature. Postoperative follow-up for 2 years shows that all the patients have remained Free from serious problem in their sexual life. We believe that above single-staged operation is worth application to the case of Peyronie`s disease concurrent with venogenic impotence.

Ligation of Crura Penis for Impotence Due to Perineal Venous Leakage / 대한비뇨기과학회지

The 2 venous pathways that assure drainage of the corpora cavernosa are the deep dorsal and the perineal venous pathways. The deep dorsal vein have been investigated but the perineal pathway has received little attention. Recently, attention was focused on the prominent part of the perineal venous system in impotence. In our hospital during last 2 years, 12 consecutive impotent man who failed to achieve an erection after intracorporeal papaverine injection and revealed intact arterial system on Duplex-sonography underwent pharmacocavernosometry -cavernosography. Venous leakage was demonstrated in 12 patients : dorsal in 6, perineal in 4 and dorsal plus perineal leakage in 1. The perineal venous system consists of veins arising from the crural edge of both corpora and ligation of the crura penis seems to be efficient in the treatment of impotence owing to their leakage. We performed ligation of crura penis in two primary erectile impotence patients who was demonstrated perineal venous leakage on cine-cavernosography. Follow-up was approximately 12 months. One patient reported marked improvement in penile rigidity at erection allowing satisfactory intercourse, but another no improvement. Obvious question is whether simple ligation of the veins draining the corpora will correct the impotence in a man with a venous leakage. Therefore further studies on etiologic factors in venous leakage must be performed before definite treatment can be made.