Long-term results of radical venous surgery in men with primary veno-occlusive erectile dysfunction

Aim: to study the long-term effectiveness of stimulation of the vein-occlusive mechanism by the addition of autologous stem cells and PRP therapy in the surgical removal of venous leak.Materials and Methods: comprehensive examination and treatment of 156 patients with vein-occlusive erectile dysfunction was carried out. Most of them – 112 (82.9%), – had left-sided or bilateral varicocele. In 86 patients of the first group with a proximal form of vein-occlusive erectile dysfunction, ligation of deep dorsal veins and veins of the penis and Marmara operation from a foam-pubic incision were performed. In 49 patients of the second group with a distal form of vein-occlusive erectile dysfunction, embolization of deep dorsal veins and veins of the Santorini plexus was performed through a conductor in the deep dorsal vein of the penis. To improve the venous occlusion mechanism, 1 million autologous endothelial stem cells and 2 millions autologous fibroblast stem cells were injected into each cavernous body, which were activated by vascular growth factor into the ligated veins (deep dorsal and large veins of the penis) in a retrograde direction during occlusive operations for 48 patients (groups 1b and 2b, respectively) and compared long-term results.Results: The effectiveness of surgical treatment according to subjective data (IIEF questionnaire) – after 2 months was almost equal, but after 18 months it was significantly higher in subgroups 1b and 2b (68,9% и 75,5) and according to objective data (no venous leakage with dopplerography of the penis), after 18 months in 73.4% and 91.4%, respectively.Conclusions: The use of autologous (endothelial and fibroblast) stem cells with the course of PRP therapy improves the veno-occlusive mechanism, increases the efficiency and long-term results of vein-occlusive surgeries for the treatment of VOED, creating an effective alternative to phalloprosthetics for men with this problem.

Download Full-text

Long-term results of dorsal penile vein ligation for symptomatic treatment of erectile dysfunction

Andrologia ◽

10.1111/j.1439-0272.1999.tb01454.x ◽

2009 ◽

Vol 31 (S1) ◽

pp. 77-82 ◽

Cited By ~ 7

Author(s):

G. Popken ◽

A. Katzenwadel ◽

U. Wetterauer

Keyword(s):

Erectile Dysfunction ◽

Symptomatic Treatment ◽

Long Term Results

Download Full-text

Early and long-term results of physical methods in the treatment of venous leg ulcers: randomized controlled trial

Phlebology The Journal of Venous Disease ◽

10.1258/phleb.2010.010048 ◽

2011 ◽

Vol 26 (6) ◽

pp. 237-245 ◽

Cited By ~ 18

Author(s):

J Taradaj ◽

A Franek ◽

L Cierpka ◽

L Brzezinska-Wcislo ◽

E Blaszczak ◽

...

Keyword(s):

Drug Therapy ◽

Laser Therapy ◽

Therapy Group ◽

Compression Therapy ◽

Long Term Results ◽

Leg Ulcers ◽

Physical Methods ◽

Venous Leg Ulcers ◽

Venous Surgery

Objective To estimate early and long-term results of physical methods in the treatment of venous leg ulcers. Method In group A after surgical operation, 40 patients were treated with the high-voltage stimulation (HVS) (100 µs, 100 Hz, 100 V) and drug therapy. In group B after operation, 37 patients were treated with ultrasound (0.5 W/cm2, 1 MHz) and drug therapy. In group C after operation, 33 patients were treated with low-level laser therapy (LLLT) (810 nm, 65 mW) and drug therapy. In group D after operation, 35 patients were treated with the compression stockings (25–31 mmHg) and drug therapy. In group E after operation, 37 patients were only treated with drug therapy. Group F consisted of 32 patients, conservatively treated with the HVS and drug therapy. Group G consisted of 20 patients, conservatively treated with ultrasound and drug therapy. Group H consisted of 21 patients, conservatively treated with LLLT and drug therapy. Group I consisted of 30 patients, conservatively treated with compression and drug therapy. Group J consisted of 27 patients only treated with drug therapy. Results Both short and long term parameters showed that compression therapy is the most efficient in ulcer healing. The electrical and ultrasound methods are less effective. The laser therapy ared useless. Conclusion Superficial venous surgery in addition to compression therapy is the most efficient treatment of venous leg ulcers. The compression therapy should be continued both surgically and conservatively treated patients with healed ulcers. In special cases after superficial venous surgery (isolated superficial reflux) compression therapy could be applied only to the time of ulcer closure without continuing it longer. HVS and ultrasound therapy are useful methods in conservative treatment of venous leg ulcers. For surgically-treated patients these physical therapies are efficient only in superficial plus deep reflux cases. HVS and ultrasound can be alternative methods, but are less effective in recurrence risk. LLLT is not an efficient physical method in treatment of venous leg ulcers.

Download Full-text