New treatment of increased venous drainage in organic impotence: ligation of internal iliac veins.

The internal iliac vein is the main confluent of the periprostatic and pudendal plexus. Therefore, it seems logical to ligate both internal iliac veins in impotent patients with increased venous drainage. The procedure was performed on 52 men and combined with ligation of collaterals to the saphenous and femoral veins in 32 of them. Erectile capacity improved in 36 patients (70%). Occasional papaverin injections and local nitroglycerin application were of help in 10 patients. Failures in 16 of 52 cases were mainly due to neurovascular lesions in diabetics.