Objective criteria in the long-term evaluation of penile venous surgery.

Caverno-venous leakage is a frequent cause of impotence and, since venous network resection gives poor results, a study was performed to evaluate the prognostic factors of this surgical procedure. A total of 23 patients underwent surgery for caverno-venous leakage. With a minimum followup of 1 year, 12 patients had normal erections for sexual intercourse. No significant difference was observed in patient age or maintenance flow rates between the responders and nonresponders. Objective quantification of the percentage of smooth muscle cells using computerized image analysis after immunohistochemical staining (desmin antidesmin) for smooth muscle cells on cavernous biopsies performed during the operation allowed us to differentiate significantly between the 2 groups. All responders had greater than 29% smooth muscle cells. Biopsy of the cavernous body with quantification of the different intracavernous structures seems to be a prognostic factor in selecting impotent patients for vascular reconstruction.