Venous fistula is a male reproductive disease, which mainly refers to the abnormality of the venous system of the corpus cavernosum of the penis, which will cause the corpus cavernosum to be unable to erect normally, thereby causing symptoms of impotence in men. It will cause the patient's corpus cavernosum to become fibrotic and lose elasticity, and the penis corpus cavernosum cannot be controlled by nerves. This requires timely treatment, and there are many treatment methods, such as some surgical treatments. Treatment It mainly blocks the venous blood backflow in the corpus cavernosum of the penis by ligating the veins, thereby achieving effective erection of the penis. 1. Indications for surgery: Congenitally thick or excessive penile veins, abnormal communicating branches between the corpus cavernosum of the penis and the corpus cavernosum of the urethra, which is common in congenital malformations or those who undergo shunt surgery due to priapism. Patient selection was based on good arterial response to ultrasound Doppler examination; poor response to cavernous injection therapy and vacuum negative pressure device; ex-smokers; no severe systemic diseases such as diabetes and arteriosclerosis; and age less than 60 years old. Repeated corpus cavernosum pressure measurement or corpus cavernosum radiography before surgery is very helpful in clarifying the path of venous leakage and determining the surgical approach. 2. Surgical methods: 1. Ligation of the deep dorsal vein of the penis 2. Ligation of the corpus cavernosum vein of the penis 3. Ligation of the corpus cavernosum vein of the penis 4. Urethral cavernous stripping 5. Ligation of the bilateral internal iliac veins.Deep dorsal vein ligation of the penis is a surgery to treat venous leakage impotence by ligating the deep dorsal vein of the penis. It can be performed under local or spinal anesthesia. Make a 3 cm long incision on the dorsal side of the penis from the base downward. The deep dorsal vein of the penis is located in the groove formed by the corpus cavernosum on the upper and lower sides of the penile fascia, and the dorsal artery of the penis can be seen on both sides. After finding the deep dorsal vein of the penis, you can free the vein 5 cm from the base of the penis to the distal end, ligate its branches, then ligate both ends of the main trunk and cut off a 5 cm long deep dorsal vein. After the vein is ligated and cut, papaverine and phentolamine can be injected immediately to induce artificial erection. First, tie a tourniquet at the base of the penis, and then inject 60 mg of papaverine and 2 mg of phentolamine into the corpus cavernosum of the penis on one side. The tourniquet was released after 2 minutes, and some patients experienced erection after about 10 minutes. At this time, 100ml of normal saline can be injected into the corpus cavernosum at a rate of 60ml/min, and the penis will have a good erection, proving that the ligation operation is successful. |
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