Cavernous body reduction in four patients with erectile dysfunction due to insufficient venous occlusion and a deficit of elastic fibers in the tunica albuginea

The corpora cavernosa are cylindrical vessels containing fluid under pressure. Thus, if cavernous wall resistance decreases, the radius increases and internal pressure decreases (LaPlace's law). We reasoned that if we decrease the corpus cavernosum radius, by excising a strip from each tunica a...

Full description

Saved in:
Bibliographic Details
Published in:International Brazilian journal of urology 2007-12, Vol.33 (6), p.785-794
Main Authors: Iacono, Fabrizio, Prezioso, Domenico, Chierchia, Stefania, Galasso, Raffaele, Iapicca, Gennaro, Di Martino, Mario
Format: Article
Language:English
Subjects:
Adult
Blood Flow Velocity
corpora cavernosa
elastic fibers
Elastic Tissue - pathology
Elastic Tissue - physiopathology
erectile dysfunction
Humans
Impotence, Vasculogenic - physiopathology
Impotence, Vasculogenic - surgery
Male
Middle Aged
Penis - blood supply
Penis - surgery
Postoperative Period
tunica albuginea
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The corpora cavernosa are cylindrical vessels containing fluid under pressure. Thus, if cavernous wall resistance decreases, the radius increases and internal pressure decreases (LaPlace's law). We reasoned that if we decrease the corpus cavernosum radius, by excising a strip from each tunica albuginea, intracavernous pressure would increase during erection. We treated with this procedure, four patients (mean age 41.5) with long-standing erectile dysfunction due to veno-occlusive dysfunction, non-responders to phosphodiesterase-5 inhibitors and intracavernous PGE1 injection. Two months post-surgery, intracavernous PGE1 (40 mcg) induced a satisfactory erection in two patients and a 45% and 58% tumescence in the other two. PGE1 responders also responded to 100 mg sildenafil. After 100 mg sildenafil and 20 mg tadalafil, the two non-responders had erections that enabled penetration but were short lasting. The procedure described could be more effective than cavernous revascularization operations. The results seem to confirm the mathematical assumptions.
ISSN:1677-5538
1677-5538
1677-6119
DOI:10.1590/S1677-55382007000600006