Venous leakage: surgical treatment of a curable cause of impotence.

While the arterial aspects of erectile impotence recently have received considerable attention, the venous component of normal and impaired erection has been ignored. In this study venous leakage was demonstrated by inducing passive erections using a controlled perfusion of the corpora cavernosa with continuous pressure monitoring. In 20 patients with impaired erectile activity under a standardized flow (80 to 120 ml. per minute) no rigid erections were obtained and the perfused liquid was demonstrated to escape through the deep dorsal vein of the penis. After ligation of this vein the erections improved sufficiently to allow satisfactory intercourse in 16 of the 20 patients. The 4 failures had serious arterial lesions. In patients with organic impotence the venous pathological condition should be assessed routinely, since it represents an easily correctable anomaly if arterial inflow is not severely impaired.