Quantitative and Qualitative Analysis of Dynamic Cavernosographies in Erectile Dysfunction due to Venous Leakage

Of 521 patients with erectile dysfunction in whom a
multidisciplinary approach was used, 145 (27.8%) showed venous
leakage as (concomitant) etiology of the impotence in dynamic
cavernosography. The rate of the maintenance flow corresponded well
with the response to a standardized intracavernosal injection of
vasoactive drugs (p < 0.05) in patients with venous leakage. The
maintenance flow increased with the age in secondary impotent men.
It was not statistically different in patients with or without
concomitant arterial insufficiency (p = 0.19). Fifty-one of 145
patients (32.2%) presented a pathologic cavernosal drainage via a
single venous system; 94/145 (64.8%) showed a combined venous
leakage. The type of leakage corresponded neither to the
maintenance flow nor to the response to intracavernosal injections.
Our findings show that standardized intracavernosal testing and
Doppler have a high predictive value for the status of the venous
occlusive system. Exact evaluation of the type of leakage can be
made by bidimensional cavernosography only.