Erectile dysfunction and caverno-venous leak disease

Abstract

Erectile dysfunction is an increasing issue, especially in young man. Whereas the current treatment strategies are mostly focused on older men, young patients are seeking more for a longer lasting or definitive solution, rather than a lifelong medical treatment. Possibly, this is a reason why currently 70% of men with erectile dysfunction are not under treatment.This aspect becomes also a socioeconomic relevance, as this generation of patients can also be called the backbone of most societies. As a logical consequence the treatment strategies in different stages of life should be reviewed. Whereas various chronic disorders have been reported to be associated with elevated rates of ED including depression, diabetes, cardiovascular and neurological diseases in older men, the young generation is more suffering from vascular problems which affects the storage capacity of the penis. The aim of this work is to review the efficiency of newly developed minimal invasive treatment strategies for this blood storage problem, causing erectile dysfunction which is mostly described as caverno-venous leakage. The systematic review of the literature reveals a significant number of recent studies dealing with new minimal invasive methods to provide a potential solution of caverno-venous leakage. Even long-term results reported demonstrate considerable improvement of erectile dysfunction caused by this condition. Furthermore, 3D-Computed tomography cavernosography (CT-cavernosography) is a new technology, which can provide high-resolution images of venous drainage from any angle and shows to be very helpful for both the diagnosis of corporal veno-occlusive dysfunction and the anatomical study of the human penile venous system. The application of this technology may also lead to better strategies in venous leak treatment. In summary, over 30 published studies could be found in the literature with constantly good results after caverno-venous leak treatment. Altogether, 13 comparable studies including 538 patients could be found, in which a mean short-term success rate of almost 80% and a mean long term success rate of 74% was achieved. None of the studies described major complications. These encouraging results should lead to reconsider or current strategy in treatment of erectile dysfunction in young men.