Current surgical treatments for erectile dysfunction consist of correction of venous leak, arterial revascularization for inflow insufficiency and implantation of penile prostheses. Only the last of these, however, may truly be described as resulting in a reliably satisfactory outcome. In addition, patients with considerable deformity due to Peyronie’s disease may be helped by surgery designed to correct the penile curvature.
Correction of venous leak
Wespes originally described venous leak as a cause of erectile dysfunction. It was hoped that simple excision/ligation of the deep dorsal vein would be curative (Figure 70). However, leakage points are usually multiple and, unfortunately, the improved function resulting from this procedure, even when combined with bilateral plication of the corpora or embolization of pelvic veins, is usually only temporary. This procedure should only occasionally be performed in fully informed consenting patients.
Wespes originally described venous leak as a cause of erectile dysfunction. It was hoped that simple excision/ligation of the deep dorsal vein would be curative (Figure 70). However, leakage points are usually multiple and, unfortunately, the improved function resulting from this procedure, even when combined with bilateral plication of the corpora or embolization of pelvic veins, is usually only temporary. This procedure should only occasionally be performed in fully informed consenting patients.
