Evaluating Penile Venous Surgery for Erectile Dysfunction After Injury

Surgery for erectile dysfunction

Hello Doctor: I have experienced penile injury that has led to fibrosis of the corpora cavernosa.
I have noticed that my penis can still achieve an erection with sufficient stimulation (manual or oral), and it is firm enough for vaginal penetration, but it tends to soften easily.
I recently underwent cavernosography, which showed that one side of the penis retained the contrast agent, while the injured side could not, possibly indicating a venous leak due to the injury.
I would like to ask:
1.
What is your opinion on "penile venous ligation surgery"? It is quite expensive, but after reviewing information online (from Dr.
Hsu Cheng-Rong and Dr.
Hsieh Cheng-Hsing), I am quite interested in this procedure.
Have you encountered patients in clinical practice who have undergone this surgery, and how beneficial has it been for them?
2.
When my penis was first injured, a hard lump appeared at the injury site, but urologists I consulted at the time said it was nothing to worry about.
The lump gradually subsided and is now difficult to observe, but I can still feel it.
I am wondering if starting vitamin E now (over four years after the injury) would be effective in completely eliminating the lump and possibly enhancing sexual function.
Thank you.

your, 20~29 year old female. Ask Date: 2016/05/05

Dr. Fu Shizhang reply Urology

1.
Due to limited experience with this type of surgery, it is difficult to provide a comment.
2.
Theoretically, the lump has the potential to gradually diminish; however, there is no guarantee that vitamin E can enhance sexual function.
Online consultations cannot replace an in-person evaluation and physical examination by a physician, and it is still recommended to seek medical attention at a healthcare facility when there are health concerns.

Reply Date: 2016/05/05

More Info

When considering penile venous surgery, particularly in the context of erectile dysfunction following an injury, it’s essential to weigh the potential benefits against the risks and costs involved. Your situation, characterized by fibrosis of the corpora cavernosa and venous leakage, is not uncommon among individuals who have experienced trauma to the penis.
1. Evaluation of Penile Venous Surgery: The surgical procedure you are referring to, often termed "penile venous stripping" or "venous ligation," aims to correct venous leakage by removing or occluding the problematic veins that prevent adequate blood retention in the penis during an erection. This surgery can be beneficial for men who have erectile dysfunction due to venous leakage, especially when conservative treatments have failed.
Clinical experiences vary, but many urologists report positive outcomes in terms of improved erectile function post-surgery. However, the success of this procedure can depend on various factors, including the extent of the injury, the presence of other underlying conditions, and the overall health of the patient. It is crucial to consult with a urologist who specializes in erectile dysfunction and has experience with this type of surgery. They can provide insights based on their clinical encounters with patients who have undergone similar procedures.

2. Regarding the Hard Lump and Vitamin E: The hard lump you experienced post-injury is likely a result of scar tissue formation, which can occur after trauma to the penis. Over time, these lumps may become less prominent, but they can persist. While Vitamin E is often touted for its potential benefits in scar healing, scientific evidence supporting its effectiveness in completely eliminating scar tissue or significantly enhancing erectile function is limited.
The use of Vitamin E may help improve the appearance of scars over time, but it is unlikely to reverse the underlying fibrosis or significantly enhance erectile function. If you are considering Vitamin E supplementation, it is generally safe, but it should be part of a broader approach to managing your erectile dysfunction. Discussing this with your healthcare provider is advisable, as they can offer tailored recommendations based on your specific condition.

In summary, penile venous surgery can be a viable option for addressing erectile dysfunction due to venous leakage, but it is essential to have a thorough evaluation by a qualified urologist. They can help determine if you are a suitable candidate for the procedure and discuss potential outcomes based on your unique circumstances. Additionally, while Vitamin E may have some benefits for scar appearance, it is unlikely to resolve the underlying issues related to erectile dysfunction. A comprehensive approach that includes medical evaluation, potential surgical options, and lifestyle modifications may provide the best outcomes for your situation.

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