Penile venous insufficiency is one of the disorders that causes erectile dysfunction in men. This disorder is treated with a venous surgery called penile dorsal vein ligation.
What is Venous Insufficiency?
The penis must have a healthy vein structure for erection and must sustain the erection. Arteries’ blood flow to the penis will start an erection, and the inner pressure of the penis will increase. With this increasing pressure, the venous blood flaps carrying the venous blood will be closed, and the erection will be maintained with high penile pressure.
If there is any leakage in these venous flaps and the erection is not hard enough, this is called venous leakage or penile venous insufficiency.
What are the Venous Insufficiency Symptoms?
The most important symptom of venous insufficiency is not sustaining an erection. The main complaint of the patients was a soft penis or not sustaining an erection. There might not be any erections in more severe venous insufficiency cases. This problem can be seen among men of all age groups and causes erectile dysfunction.
If venous insufficiency is left untreated, this disease might cause health and psychological problems, preventing a healthy sexual life.
How is Venous Insufficiency Diagnosed?
The most important step in venous insufficiency diagnosis is the patient’s medication history. Typically, patients complain about not having the desired hardness or sustaining hardness. Younger patients often suffer more from venous insufficiency than older patients. In addition, patients with venous insufficiency do not benefit from medication, needle or shock wave treatments. The only solution is dorsal venous ligation surgery. Penile Doppler ultrasound must be applied for diagnosis.
The radiologist performing the ultrasound must know the vein anatomy of the penis. The penis has two important venous structures, called the superficial dorsal venous and deep dorsal venous, and these venous structures are connected. The correct venous anatomy before surgery is important in terms of surgical success. It is important to remember that this is a cardiovascular disease, and the treatment must be planned accordingly.
What Causes Venous Insufficiency?
Venous insufficiency is a cardiovascular disorder. Factors, such as diabetes, high cholesterol, cancer treatment, smoking and genetics, that impact cardiovascular health are venous insufficiency risk factors.
How is Venous Insufficiency Treated?
The only treatment option for penile venous insufficiency is surgical treatment. Penile venous surgery, known as penile dorsal venous ligation, must be performed by andrologists with a good knowledge of penis venous anatomy. The penis’s venous structure consists of 2 structures: the superficial dorsal venous and the deep dorsal venous. These two venous structures are connected. If this connection is not removed during surgery, the surgical treatment will have a lower success rate.
Therefore, connecting the superficial venous alone offers insufficient treatment. A Doppler ultrasound before surgery should provide the detailed vein anatomy, and a detailed plan should be constructed. Although venous surgery seems unsuccessful, it is possible to achieve positive results when performed by experienced andrologists.
I Decided to have Dorsal Venous Ligation. How does the Process work?
After making the decision to undertake surgery, a detailed venous map will be prepared for the patient. The surgery is planned based on this map, and the surgery takes approximately 1.5–2 hours. The surgeon must know the penis’s anatomy, since the venous is close to the nerves.
Another important factor is selecting suitable candidates for surgery. The problems should be correctly identified as venous insufficiency. Otherwise, patients will not benefit from this treatment.