Is the recurrence rate of venous leak surgery high?

I believe that many people have not heard of varicose vein surgery, and they are even less aware of the success rate and recurrence rate of the surgery. Therefore, in order to increase everyone's introduction to the recurrence rate of varicose vein surgery, I hope everyone can understand the following content. Because varicose vein surgery mainly occurs in male friends, it will cause abnormal reflux of the cavernous vein of the penis, causing symptoms of impotence and erectile dysfunction.

When an abnormality occurs in the venous system of the corpus cavernosum of the penis, the intracavernosal pressure cannot reach 80 mmHg, or the corpus cavernosum venous return system cannot be effectively closed, the venous return cannot be effectively reduced during erection, and a large amount of blood leaks from the veins, resulting in the penis being unable to erect normally or having an inadequate erection.

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 too thick or too many penile veins, abnormal communication branches between the penile corpus cavernosum and the urethral corpus cavernosum, are common in patients with congenital malformations or those who have undergone 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.