Diagnosis and treatment of venous leakage: a curable cause of impotence

Br J Urol. 1988 Feb;61(2):151-5. doi: 10.1111/j.1464-410x.1988.tb05066.x.


Sixteen of 149 patients complaining of impotence of a non-neurogenic or endocrine aetiology and with a penile brachial index of greater than 0.7 failed to achieve an erection following intracavernosal injection of 30 mg papaverine and 1 mg phentolamine. All 16 were shown to have a significant venous leak using digital subtraction cavernosography. Nine of the 13 so far operated upon have had a full return of potency. Repeat cavernosography in three failures showed persistent leakage into crural veins in two and non-ligated superficial veins in one. Impotent men with a normal penile brachial index who fail to respond to papaverine and phentolamine have a venous leak, a curable cause of impotence. Surgical access should allow ligation of all identified leaking veins.

MeSH terms

  • Adult
  • Erectile Dysfunction / diagnosis
  • Erectile Dysfunction / etiology
  • Erectile Dysfunction / surgery*
  • Humans
  • Male
  • Middle Aged
  • Papaverine
  • Penile Erection / drug effects
  • Penis / blood supply*
  • Penis / diagnostic imaging
  • Phentolamine
  • Phlebography
  • Regional Blood Flow
  • Subtraction Technique
  • Veins / surgery


  • Papaverine
  • Phentolamine