Tehran University Medical Journal

Erectile dysfunction is an important problem for men and their families which has an organic cause in about 50 percent of cases. When there is a vasculogenic etiology for this defect, radiologic assessment is unavoidable. Cavernosometry and Cavernosography are ultimate procedures for diagnosis of venous leakage. There is no reliable data about this defects in Iran. The objective of this study was to determine the rate of venous leakage in patients with erectile dysfunction by Pharmarco-Cavernosometry and Cavernosography. In this case series study, 100 patient with erectile dysfunction who referred to radiologic ward in Sina hospital was selected and Pharmarco-Cavernosometry and Cavernosography were conducted for them. In Cavernosometry, after injection of Prostaglandin E1 and salin normal infusion into corpus covernosum, the pressure was determined. In cavernosography, diluted omnipaque was injected and venous leakage and other defects were recognized. Myoclinic's criteria was use for analysis of the results. Mean age of patients was 35.6±11.6. Most of the cases were in 20 to 40 age group. The frequency of venous leakage based on 50 mmHg reduction in pressure (from 150 mmHg), after 30 seconds discountinuance of normal salin infusion was 90 percent. This figure based on the ratio of Maintenance Flow Rate to Induced Flow Rate, was more than 92 percent. The frequency of venous leakage according to Cavernosography was 89 percent. There was no significant side effects in any of cases induced by procedures. The results of study, shows the high prevalence of venous leakage in patients referring for erectile dysfunction.

Erectile dysfunction is an important problem for men and their families which has an organic cause in about 50 percent of cases. When there is a vasculogenic etiology for this defect, radiologic assessment is unavoidable. Cavernosometry and Cavernosography are ultimate procedures for diagnosis of venous leakage. There is no reliable data about this defects in Iran. The objective of this study was to determine the rate of venous leakage in patients with erectile dysfunction by Pharmarco-Cavernosometry and Cavernosography. In this case series study, 100 patient with erectile dysfunction who referred to radiologic ward in Sina hospital was selected and Pharmarco-Cavernosometry and Cavernosography were conducted for them. In Cavernosometry, after injection of Prostaglandin E1 and salin normal infusion into corpus covernosum, the pressure was determined. In cavernosography, diluted omnipaque was injected and venous leakage and other defects were recognized. Myoclinic's criteria was use for analysis of the results. Mean age of patients was 35.6±11.6. Most of the cases were in 20 to 40 age group. The frequency of venous leakage based on 50 mmHg reduction in pressure (from 150 mmHg), after 30 seconds discountinuance of normal salin infusion was 90 percent. This figure based on the ratio of Maintenance Flow Rate to Induced Flow Rate, was more than 92 percent. The frequency of venous leakage according to Cavernosography was 89 percent. There was no significant side effects in any of cases induced by procedures. The results of study, shows the high prevalence of venous leakage in patients referring for erectile dysfunction.

Background: Erectile dysfunction is an important problem in men and an organic cause is found in about 50% of cases. When a vasculogenic etiology is suspected, imaging assessments are of great help. Cavernosography is traditionally recognized as an imaging modality for evaluation of venous leakage in men with impotency. We employed CT cavernosography as a novel technique for demonstrating penile venous anatomy and leaking veins.
Methods: In the present case series study, we recruited 45 patients with erectile dysfunction by convenient sampling at Hazrat Rasoul Akram Hospital in Tehran, Iran, during one year (1390). The patients had previously been diagnosed with venous incompetency by Doppler study. After intracavernosal injection of prostaglandin E1, we injected sterile normal saline into the corpora cavernosa to achieve penile erection. Later, we injected contrast media into the corpus cavernosum, which was followed by CT scan of the penis and pelvic area to show the venous anatomy and leakage sites.
Results: The mean age of the patients was 35.8±8.9 years. 36 (80%) patients had venous leakage in crural veins, 27 (60%) in cavernosal veins, 27 (60%) in circumflex veins, 24 (52.3%) in urethral veins, 21 (46.7%) in deep dorsal vein, 3 (6.7%) in para-arterial veins and 3 (6.7%) in corpus spongiosum.
Conclusion: The results of this study show the high prevalence of venous leakage in patients referring for erectile dysfunction. Moreover, CT cavernosography was shown to be a useful method for evaluating penile venous system and its related leakage sites which are important for surgical planning.