Another surgical approach for vasculogenic impotence.

Until recently, a defect in the capability of blood to be trapped in the corpus cavernosum so that adequate penile turgidity can be maintained for successful intercourse has not been considered a major etiology for impotence. A diagnostic test called dynamic cavernosography was developed that consists of a cine-taped cavernosogram in conjunction with intracavernous pressure measurements at 3 different cavernous infusion rates. The results of 104 of these tests are presented. More recently, 17 of these patients also have undergone papaverine tests. Of the patients 59 per cent had no or only partial erections at all infusion rates and pressure did not increase to greater than 50 mm. Hg. The papaverine test showed only partial or no tumescence when 60 mg. were injected into the corpora. As a result, 25 patients underwent a penile operation to remove some venous outflow channels. Of the patients who underwent an operation for absent tumescence at any flow rate and who had a large number of venous channels draining the corpora cavernosa on the cavernosogram 59 per cent were potent postoperatively.