Penile venous surgery.

Excessive venous flow during erection is an acknowledged cause of impotence. At the turn of the century, Wooten and Lydston reported a cure rate of roughly 50 per cent after ligation of the deep dorsal vein of the penis. In 1979, Ebbehoj and Wagner restored potency in three of four patients with venous leakage. Later, Virag reported the diagnostic technique of dynamic cavernosography and proposed deep venous ligation. In 1985, Wespes and Schulman reported an 80 per cent success rate for correction of venogenic impotence by ligating the deep dorsal vein and its tributaries. Since then, Bennett and associates have achieved success in six of eight patients, and Lewis and Puyau report a 50 to 75 per cent success. With the technique described above, after careful selection and proper diagnostic testing, impotence has resolved or erection improved in more than 80 per cent of our patients.