How to diagnose penile venous leakage

Penile venous leakage refers to the symptom of damage and rupture of the corpus cavernosum in the penis, which will cause congestion of the penis and bleeding from the glans penis, causing erectile dysfunction and difficulty in erection in men, affecting the sexual life of couples. Therefore, patients with penile venous leakage should be treated with deep dorsal vein ligation surgery in time, and then pay attention to penile hygiene issues and avoid sexual intercourse.

Penile venous leakage refers to the situation that due to the damage and tearing of the cavernous body in the penis, blood leaks into the glans penis or other blood vessels when the penis is engorged. The main clinical symptoms it causes are erectile dysfunction or even erectile dysfunction, which seriously affects the patient's sexual life. For this situation, it is recommended to prevent the venous blood from flowing back into the cavernous body by ligating the vein, which can achieve effective erection of the penis. The commonly used surgical method is deep dorsal vein ligation of the penis.

Causes

The occurrence of venous leakage is often caused by the malfunction of the passive pressure closure mechanism of the penile subtunica albuginea vein, including incomplete relaxation of the corpus cavernosum smooth muscle, abnormal neural control, and loss of elasticity caused by fibrosis of the corpus cavernosum.

Check

1. Spongy body pressure measurement

2. Spongiostomy

3. Color dual-function ultrasound, etc.

Treatment

Purpose of surgery

It mainly blocks the venous blood backflow in the corpus cavernosum of the penis by ligating the veins, thus achieving effective erection of the penis.

Surgical Indications

Congenitally thick or excessive penis veins, abnormal communication branches between the penile corpus cavernosum and the urethral corpus cavernosum, are common in patients with congenital malformations or undergoing shunt surgery due to priapism. Patient selection should refer to good arterial response to ultrasound Doppler examination; poor results of corpus cavernosum injection therapy and vacuum negative pressure device; quit smoking; no severe systemic diseases such as diabetes and arteriosclerosis; age less than 60 years old. Repeated penile corpus cavernosum pressure measurement or penile corpus cavernosum radiography before surgery is very helpful in clarifying the path of venous leakage and determining the surgical method.

Surgical method

1. Dorsal deep vein ligation

2. Ligation of the penile corpus cavernosum

3. Corpus cavernosum ligation

4. Urethral Corpus Cavernosa Stripping

5. Bilateral internal iliac vein ligation.

Surgical method

The deep dorsal penis vein ligation surgery is a surgery to treat venous leakage impotence by ligating the deep dorsal penis vein. It can be performed under local anesthesia or spinal anesthesia. A 3cm long incision is made on the dorsal side of the penis from the root downward. The deep dorsal penis vein is located in the groove formed by the corpus cavernosum on the upper and lower sides of the penile fascia, and the dorsal penis artery can be seen on both sides. After finding the deep dorsal penis vein, this vein can be moved 5cm away from the root of the penis to the distal end, and its branches are ligated, and then the two ends of the main trunk are ligated, and a 5cm long dorsal deep vein is cut. After the vein is ligated and cut, you can immediately inject poppyrine and phentolamine to induce artificial erection. First, tie a tourniquet at the base of the penis, and then inject 60mg of poppyrine and 2mg of phentolamine into the cavernous body of the penis on one side. Loosen the tourniquet after 2 minutes, and some patients will have an erection after about 10 minutes. At this time, you can use 100ml of physiological saline to inject it into the cavernous body at a speed of 60ml/min, and the penis will have a good erection, proving that the ligation operation is successful.