53 / 65
Page 77
May 24-25, 2018
London, UK
Vascular Surgery 2018
3
rd
Edition of World Congress & Exhibition on
Vascular Surgery
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Chi Can Huynh et al., J Vasc Endovasc Therapy 2018, Volume 3
DOI: 10.21767/2573-4482-C1-002
I
s coil embolization effective and safe to treat impotence
resulting from veno-occlusive dysfunction, we report five cases
and literature review. From 2012 to 2017, refractory impotence
prompted five young men to consult us despite coil venous
embolization performed elsewhere. All patients were evaluated
withgeneral x-ray, Doppler sonography, computerized tomography,
the abridged 5-item version of the international index of erectile
function (IIEF-5) and our dual pharmaco-cavernosography. They
were treated with the latest method of penile venous stripping
which was carried out with circumferential and pubic longitudinal
approaches under acupuncture aided local anesthesia. The
deep dorsal vein, cavernosal veins were thoroughly stripped
while the para-arterial veins were ligated segmentally. Follow-
up cavernosography was routinely conducted for confirming
sufficient venous stripping and comparison of radio-opacity
between the femoral cortex and the corpora cavernosa especially
the penile crura while the IIEF-5 follow was merely made via
the internet. A review of the literature on coil embolization
was obtained using Medline. Coils migration took place in four
patients in which each two were found in pelvic and pulmonary
area respectively and one patient disclosed dozens of coils in
the periprostatic plexus, all had no improvement in impotence.
Postoperative cavernosography discloses the radio-opacity of the
penile crura was denser than that of the femoral cortex. However,
the IIEF-5 score changed from 10.4±2.4 to 15.9±2.8, p 0.001. One
man required additional oral sildenafil and two men ended with a
penile implant. Coil migration was not uncommon in the medical
literature, which varied from 2.5% to 11.1%. The efficacy of penile
venous embolization appears controversial, and its safety may
not be sustainable although larger samples may be required.
Recent Publications
1. Hsu G L, Chen H S, Hsieh C H, Lee W Y, Chen K L and
Chang C H (2010) Clinical experience of a refined penile
venous stripping surgery procedure for patients with
erectile dysfunction: is it a viable option? Journal of
Andrology 31:271-280.
2. Hsu G L, Chen H S, Hsieh C H, Lee W Y, Chen K L and
Chang C H (2010) Salvaging penile venous stripping
surgery. Journal of Andrology 31:250-260.
3. Hsieh C H, Liu S P, Hsu G L, Chen H S, Molodysky E, Chen
Y H and Yu H J (2012) Advances in our understanding
of mammalian penile evolution, human penile anatomy
Is coil embolization effectively and minimally invasive in the
young man suffering from veno-occlusive dysfunction?
Chi Can Huynh
1
and
Geng Long Hsu
2, 3
1
The Male Clinic, Australia
2
Hsu’s Andrology, Taiwan
3
National Taiwan University, Taiwan
Figure 1:
Imaging of patients who received prior penile venous embolization.
(A) Several embolization coils are likely lodged in the pulmonary artery
and further confirmed by contrast CT Scanning which disclosed one coil
perforated cardiac right ventricle. In recent years, the patient was susceptible
to hemoptysis. (B) A cavernosogram of another patient disclosed several
dozens of coils lodged in the Santorini plexus