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The e-mémoires of the Académie Nationale de Chirurgie

New procedure for the treatment of cavernous-venous leaks: results of simultaneous open surgery and embolization in 171 patients.

Eric ALLAIRE | Ronald VIRAG | Sylvain ORDUREAU | Hélène SUSSMAN | Pascal HAUET | Jean FLORESCO | Christophe CRUL

Seance of wednesday 15 november 2023 (L'érection: quoi de neuf en 2023)

DOI number : 10.26299/cxyf-zr58/emem.2023.32.01

Abstract

We present the results of open surgery and embolization combined in the same procedure in 171 patients with drug-resistant erectile dysfunction due to cavernovenous leaks (CVL), diagnosed by penile duplex sonography and cavernous CT. The average age was 43.8±13.6 years (18-76).
Three months after the intervention, the EHS score after pharmacological stimulation was increased from 2.56±.66 to 3.40±.56 (p<.0001), all CVL hemodynamic parameters were improved (p<.0001).

After a mean follow-up of 22.8±19.7 months (3-85), the IIEF-5 score increased from 10.7±5.1 to 15.9±5.8, the EHS during sexual intercourse from 1.94±.67 to 3.31±.75, the rate of successful penetrations from 20.1±30.9 to 70.4±37.6% (p<.0001 for all parameters), the success rate was 80.7%.
This new procedure combining surgery and embolization makes it possible to treat all leaks, a necessary condition for clinical success, and a return to sexuality with effective erections in 80% of patients with venous leaks.