Lewis R W
Mayo Medical School, Rochester, Minnesota.
Urol Clin North Am. 1988 Feb;15(1):115-21.
Venous surgery for impotence is in a dynamic state. The drainage of the corpora cavernosa normally occurs through the crural veins or the cavernous veins and the deep dorsal penile vein. Patients with drainage seen on cavernosography only into a superficial system that persists after injection of intracavernous vasoactive agents are likely to have good results if this drainage is eliminated. This type of patient is not common. A surgical approach that attempts to eliminate the deep dorsal penile system or the crural veins is not as successful. Perhaps subtle arterial disease, concurrent presence of neurologic disease, and collateralization all add to the significant failure rate. Many failures of spontaneous erection will, however, respond to intracavernous injection of vasoactive agents postoperatively. Deep dorsal vein arterialization probably should be reserved for those patients who have an arterial component to their impotence as well as a venogenic cause.
用于治疗阳痿的静脉手术尚处于动态发展阶段。海绵体的引流通常通过脚静脉、海绵体静脉以及阴茎背深静脉进行。在海绵体造影中，若仅见注入海绵体内血管活性药物后仍持续存在的浅表系统引流，消除这种引流后，此类患者可能会取得良好疗效。这类患者并不常见。试图消除阴茎背深静脉系统或脚静脉的手术方法并不那么成功。或许细微的动脉疾病、并发的神经疾病以及侧支循环的形成都导致了显著的失败率。然而，许多术后自发性勃起失败的患者对海绵体内注射血管活性药物有反应。阴茎背深静脉动脉化可能应仅用于那些既有动脉因素又有静脉因素导致阳痿的患者。
