Alberto Rebonato1, Alessio Auci2, Franco Sanguinetti2, Daniele Maiettini3, Michele Rossi4, Luca Brunese5, Gianpaolo Carrafiello6, Tito Torri2. 1. Department of Surgery, Radiology and Odontostomatology Sciences, Santa Maria della Misericordia University Hospital, University of Perugia, Sant'Andrea delle Fratte, Perugia, 06132; Radiology Department, ASL 1 Massa Carrara, Carrara. Electronic address: rebonatoalberto@gmail.com. 2. Radiology Department, ASL 1 Massa Carrara, Carrara. 3. Department of Surgery, Radiology and Odontostomatology Sciences, Santa Maria della Misericordia University Hospital, University of Perugia, Sant'Andrea delle Fratte, Perugia, 06132. 4. Radiology Department, St. Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "La Sapienza," Rome. 5. Department of Medicine and Health Sciences, Università del Molise, Contrada Tappino, Campobasso. 6. Department of Human Morphology, Insubria University Hospital, Varese, Italy.
Abstract
PURPOSE: To evaluate retrospectively the safety and efficacy of anterograde embolization of the periprostatic venous plexus (AEPV) via percutaneous access of the deep dorsal vein of the penis for erectile dysfunction (ED) resulting from veno-occlusive dysfunction (VOD). MATERIALS AND METHODS: From September 2009 through December 2012, 18 patients with moderate to severe ED secondary to insufficiency of physiologic venous occlusion as diagnosed by color Doppler evaluation of the penis after direct pharmacologic stimulation were treated. Preliminary diagnoses were also confirmed with dynamic cavernosography. Selective AEPV was achieved using a combination of N-butyl cyanoacrylate and endovascular coils. Follow-up consisted of collecting International Index of Erectile Function questionnaire (IIEF-6) scores and repeated color Doppler evaluation. RESULTS: Immediate technical success was achieved in 16 of 18 patients (88.8%). Follow-up data were obtained at a mean of 13.3 months ± 7.5. In 12 of the patients with technical success, the mean IIEF-6 score improved from 10.5 ± 5.2 to 20.6 ± 8.4 after the procedure (P = .0069). At 3-month short-term follow-up, clinical success defined by an end-diastolic velocity of < 5 cm/s on color Doppler was noted in 81% (13 of 16 patients). Of these 13 patients, 7 patients had continued erectile function at the end of follow-up, and the other 6 patients reported progressive diminishment in the benefit over time. No major complications and two minor complications were encountered. CONCLUSIONS: AEPV for ED secondary to VOD is a safe alternative to surgical treatment that demonstrates promising short-term and midterm efficacy.
PURPOSE: To evaluate retrospectively the safety and efficacy of anterograde embolization of the periprostatic venous plexus (AEPV) via percutaneous access of the deep dorsal vein of the penis for erectile dysfunction (ED) resulting from veno-occlusive dysfunction (VOD). MATERIALS AND METHODS: From September 2009 through December 2012, 18 patients with moderate to severe ED secondary to insufficiency of physiologic venous occlusion as diagnosed by color Doppler evaluation of the penis after direct pharmacologic stimulation were treated. Preliminary diagnoses were also confirmed with dynamic cavernosography. Selective AEPV was achieved using a combination of N-butyl cyanoacrylate and endovascular coils. Follow-up consisted of collecting International Index of Erectile Function questionnaire (IIEF-6) scores and repeated color Doppler evaluation. RESULTS: Immediate technical success was achieved in 16 of 18 patients (88.8%). Follow-up data were obtained at a mean of 13.3 months ± 7.5. In 12 of the patients with technical success, the mean IIEF-6 score improved from 10.5 ± 5.2 to 20.6 ± 8.4 after the procedure (P = .0069). At 3-month short-term follow-up, clinical success defined by an end-diastolic velocity of < 5 cm/s on color Doppler was noted in 81% (13 of 16 patients). Of these 13 patients, 7 patients had continued erectile function at the end of follow-up, and the other 6 patients reported progressive diminishment in the benefit over time. No major complications and two minor complications were encountered. CONCLUSIONS: AEPV for ED secondary to VOD is a safe alternative to surgical treatment that demonstrates promising short-term and midterm efficacy.
Authors: Antonio Arrichiello; Salvatore Alessio Angileri; Giorgio Buccimazza; Francesco Di Bartolomeo; Letizia Di Meglio; Alessandro Liguori; Martina Gurgitano; Anna Maria Ierardi; Maurizio Papa; Aldo Paolucci; Gianpaolo Carrafiello Journal: Acta Biomed Date: 2020-09-23
Authors: Sandro La Vignera; Andrea Crafa; Rosita A Condorelli; Federica Barbagallo; Laura M Mongioì; Rossella Cannarella; Michele Compagnone; Antonio Aversa; Aldo E Calogero Journal: Andrology Date: 2021-05-06 Impact factor: 3.842