Computed tomography cavernosography combined with volume rendering to observe venous leakage in young patients with erectile dysfunction.

objective: To observe the venous leakage of penile veins through cavernosometry and cavernosography, using CT combined with three-dimensional volume rendering.

methods: 186 consecutive erectile dysfunction patients (20-40 years old) with suspected venous leakage diagnosed by clinicians were enrolled. All patients underwent intracavernous injection of vasoactive agents combined with Doppler ultrasound to identify venous leakage.

results: Taking intracavernous injection combined with Doppler ultrasound as the "gold-standard", 47/186 (25.3%) patients had negative venous leakage, and 139/186 (74.7%) patients had positive venous leakage. CT cavernosography showed that 22/139 (15.8%) cases were isolated deep dorsal vein or crural vein leakage, and 117/139 (84.2%) cases were complex venous leakage. Three types of deep dorsal vein were seen: single-branch 42/139 (30.2.%), double-branch 45/139 (32.4%), and complex 31/139 (22.3%). Three types of prostatic venous plexus were seen: single-branch 26/139 (18.7%), multiple-branch 36/139 (25.9%), and plexus 39/139 (28.1%). A total of 166 crural veins were revealed in 129 patients. Crural veins had three origins: medial dorsal side (112/166, 67.5%), lateral ventral side (30/166, 18.1%) and the curs tip (24/166, 14.4%).

conclusion: To achieve the expected success rate of ligation surgery or endovascular embolization, candidates for the procedures should be carefully selected through CT cavernosography, which can provide elaborate images and information about the venous leakage. ADVANCES IN KNOWLEDGE:: A modified evaluation method was used in this study to monitor the intracavernous pressure during examination. New classifications of the deep dorsal vein, prostatic venous plexus and crural vein are described in this study.