What are the obvious symptoms of penile venous leakage

Many people are not particularly familiar with the disease of penile venous fistula. This disease is caused by damage to the corpus cavernosum of the penis, which causes cracks. This causes blood leakage from the congested penis, which is quite harmful to men. Because blood leaks from the veins, it can cause the male penis to be unable to erect normally, or the erection is not sufficient. This disease can be treated by venous ligation.

Symptoms

When the venous system of the corpus cavernosum of the penis becomes abnormal, the intracavernosal pressure cannot reach 80 mmHg, or the corpus cavernosum venous return system cannot be effectively closed, and the venous return cannot be effectively reduced during the erection process, a large amount of blood leaks from the veins, resulting in the penis being unable to erect normally or having an incomplete erection.

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, the penile veins are too thick or too many, and there are abnormal communicating branches between the corpus cavernosum of the penis and the corpus cavernosum of the urethra. This is common in congenital malformations or in those who have undergone 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 method

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.