Journal of Andrology Testis Workshop 2009
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Published-Ahead-of-Print November 19, 2009
Journal of Andrology 2009, DOI:10.2164/jandrol.109.008532

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Clinical Experience of a Refined Penile Venous Stripping Surgery Procedure for Patients with Erectile Dysfunction: Is It a Viable Option?

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.

Penile venous surgery might not be considered an appropriate treatment for erectile dysfunction (ED) because of disappointing functional outcomes and unacceptable, seemly unavoidable, penile deformity. We report results of a refined penile venous stripping method in patients with veno-occlusive dysfunction (VOD). From 2000 to 2003, 341 of 467 ED males were diagnosed with VOD via cavernosography and Doppler sonography. Patients were excluded from undertaking cavernosography if they had an untreated chronic systemic disease. Patients who underwent the first penile venous surgery in other institutes were also excluded from this study due to the protracted surgical time and unpredictable functional outcomes because severe fibrosis may prevent patients from completing penile venous removal. Of these, 178 men were treated with a refined venous stripping surgical method (surgery group) and 163 patients were treated without this surgery (control group). In the surgery group, 167 were available for long-term follow-up using the abridged five-item version of the International Index of Erectile Function (IIEF-5) scoring system. The operative time ranged 2.1~5.0 hours. The follow-up period ranged 5.1~8.2 years with an average of 7.7 ± 1.4 years. The difference between the preoperative (9.7 ± 3.9) and postoperative (21.6 ± 2.8) IIEF-5 scores was significant (P < 0.001). Overall 90.4% of the surgery group (151/167) reported improvements after surgery. A significant decrease in IIEF-5 scores (10.4 ± 3.8 v.s.7.9 ± 3.2, P < 0.001, n=121) during the same period of follow-up was, however, noted in the control group. This refined penile venous stripping surgery delivered favorable results and is a viable alternative for treating VOD.


Key words: Erectile Dysfunction • Penis • Surgery • cavernosal vein • deep dorsal vein • para-arterial vein • veno-occlusive dysfunction • venous stripping






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