What
causes impotence?
An erection happens when blood is pumped into the penis
- and stays there - making it stiff and hard. It is a complex process, involving
the blood vessels to and within the penis as well as the nervous system that
controls the flow of blood and, on top of it all, the man’s emotional state.
Many sorts of influences can therefore stop erections from occurring. .
Venous Leakage
The
most common cause of erectile dysfunction is impaired blood flow either into
or out of the penis. Hardening of the arteries, for example, reduces blood
flow into the penis at the time of stimulation. Venous leak, which results
in blood not being trapped in the penis, also can contribute to difficulty
maintaining an erection. Factors that can impede blood flow include:
- Smoking;
- Diabetes;
- Hardening of the arteries
(athersclerosis);
- Venous leak;
- Abdominal aneurysm/aneurysm repair
surgery;
- Penile injury (fractured penis);
- Pelvic steal syndrome (poor blood flow);
- Injury to penile arteries (bicycle seat,
motor vehicle accident)
Venous
Ligation Surgery
In
general, the long-term benefits of venous ligation surgery have been limited,
with short-term success rates cited between 30-50%. Venous leak is believed
to be a manifestation of structural changes in the erectile tissue and the
concept that ligation of venous channels external to the corporal body itself
can remedy venous leak in a long-term fashion has little scientific basis.
Venous ligation surgery is currently recognized as a purely investigational
form of surgery. However, preliminary evidence supports the use of such surgery
in young men with traumatic or congenital leakage from the most posterior
portions of the erectile bodies, the crura. ligation of the crura is used
to combat crural venous leak. No long-term data are available in a large cohort
of patients and at this time this procedure is considered investigational.
Prior to being considered for this procedure, young men need to undergo routine
evaluation and the vascular study, DICC. If venous leak is identified to be
present solely in the crura of the penis, then the patient is counseled about
this form of surgery.