Journal of Andrology Testis Workshop 2009
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Published-Ahead-of-Print September 10, 2009
Journal of Andrology 2009, DOI:10.2164/jandrol.109.008409

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Salvaging Penile Venous Stripping Surgery

GENG-LONG HSU *, HENG-SHUEN CHEN , CHENG-HSING HSIEH , WEN-YUAN LEE , KUO-LIANG CHEN , and CHAO-HSIANG CHANG

* To whom correspondence should be addressed. E-mail: genglonghsu{at}gmail.com.

Disappointing functional outcome and penile deformity are major concerns of penile venous surgery. Consequently it has been abandoned by most urologists. To explore whether penile deformity is correctable and erectile function can be improved, we report our experience in patients who had undergone surgery elsewhere. From 1986 to 2008, 16 consecutive patients sought our assistance because of poorer erectile capability or/and penile deformity from previous venous surgery elsewhere. The abridged five-item version of the International Index of Erectile Function (IIEF-5) was used to score the patients when it became available in 1998. Accordingly, 3 and 13 patients were categorized into the non-IIEF and IIEF groups respectively. A median longitudinal pubic incision and a circumferential or semi-circumcision were made to relieve the fibrotic tissues for accessing the deep dorsal veins which were stripped thoroughly and ligated with 6-0 nylon sutures. The cavernosal veins were managed in a similar manner. The para-arterial veins were ligated only segmentally. Finally, the wound was approximated while an assistant consistently stretched the penile shaft. The operation time was from 5.2 to 8.5 hours. The follow-up period ranged from 0.6-23.0 years. All patients reported satisfactory penile morphology postoperatively. In the IIEF group, the difference in pre-operative and post-operative scores was significant (P < 0.001). In the non-IIEF group two out of the 3 patients reported natural coitus. This series of salvaging venous surgeries, though technically challenging, are helpful in correcting penile deformity and restoring erectile function in some patients who had poorer outcomes from previous venous surgeries.


Key words: Erectile Dysfunction • Microsurgery • Penis • Surgery • cavernosal veins • deep dorsal vein • para-arterial veins • penile deformity • penile venous surgery






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