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Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
May 24-25, 2018
London, UK
Vascular Surgery 2018
Page 19
3
rd
Edition of World Congress & Exhibition on
Vascular Surgery
W
e have refined penile venous stripping, penile corporoplasty
and varicocelectomy for patients with erectile dysfunction,
penile dysmorphology and varicocele since 1999. From June
2010 to March 2016, a total of 128 men, aged from 28 to 68
years, consulted us with erectile dysfunction, penile deviation,
and a varicocele. Among these, 87 males (the surgical
group) underwent a combination of penile venous stripping,
corporoplasty and varicocelectomy, while 41 were assigned to
the control group without surgery. The abridged five-item version
of the International Index of Erectile Function (IIEF-5), a dual
cavernosography, and a life quality rating were used to assess
patients. Under an acupuncture-aided pure local anesthesia on
an ambulatory basis, these surgeries were performed. In the
surgical group, the preoperative IIEF-5 and the life quality rating
was9.7±2.1and26.7±3.6%, whichwas increasedpostoperatively
to 22.6±2.3 and 82.6±5.2% respectively (both p<0.001). Twomen
reported one and two children fertility postoperatively although
their initial chief complaints were just impotence and penile
curvature preoperatively. In the control group, the corresponding
preoperative IIEF-5 and life quality rating was 9.8±2.3 and
27.4±3.7% respectively which changed to 8.9±2.4 and 20.9±6.3%
respectively (latter p<0.01). The difference between the two
groups (p<0.001) and within the group (p<0.01) was significant.
A satisfactory penile shape was achieved in 79 (90.8%) patients
with eight men (9.0%) complaining of mild deviation of the
penis (<10°). Cavernosogram showed an ideal milieu of the
corpora cavernosa for retaining intracavernous fluid which
was particularly evidenced by significant stronger radiopacity
of penile crura than that of the femoral cortex. A combination
of penile venous stripping, corporoplasty and varicocelectomy
provides a novel solution for restoring erectile function,
penile morphologic reconstruction and fertility enhancement
with negligible morbidity. Being assisted with acupuncture
management outpatient basis is sustainable.
A combination of penile venous stripping,
corporoplasty and varicocelectomy for
patients with erectile dysfunction, penile
dysmorphology and varicocele under
acupuncture-aided ambulatory local
anesthesia
Geng Long Hsu
Hsu’s Andrology, Taiwan
Geng Long Hsu, J Vasc Endovasc Therapy 2018, Volume 3
DOI: 10.21767/2573-4482-C1-001
Figure 1:
Photos and imaging of a combination of penile venous stripping,
corporoplasty and varicocelectomy. A). A circumferential skin incision was
initiated. The visibility of the deep dorsal vein could be enhanced by a milk-
ing pressure applied on the sinusoids. It was managed and likewise, the
cavernosal veins were treated till the infrapubic angle. B). Either a modified
Nesbit procedure or a placationwasmade to the excessive tunica. C). Bilat-
eral spermatic cords were hooked out via the pubic longitudinal wound. D).
Once the vascular surgery was performed, both circumferential and pubic
longitudinal wounds were fashioned. E). The venous distribution provided
a blueprint for penile venous stripping. F). A postoperative cavernosogram
showed penile dysmorphology. G). Cavernosogramwas performed imme-
diately postoperative. H). Ideal penile morphology and ability of intracorpo-
real retention were reached