V7 Venous leakage treatment revisited- pelvic venoablation using aethoxysclerol under air block technique

V7 Venous leakage treatment revisited- pelvic venoablation using aethoxysclerol under air block technique Herwig R. Rudolfinerhaus, Dept. of Urology, Vienna, Austria INTRODUCTION & OBJECTIVES: Oral therapy with PDE5 inhibitors has become the standard treatment for erectile dysfunction (ED). However, results of PDE5 inhibitors are poor if the cause for ED is cavernous venous leakage. The aim of our study was to evaluate the short and long term results of a modified pelvic vein embolization technique with aethoxysclerol for the treatment of impotence due to venous leakage. MATERIAL & METHODS: A total of 69 patients with severe ED due to venous leakage underwent the modified embolization procedure. Venous leakage was identified by Color Doppler Ultrasound following intracavernous administration of 10 to 20 µg alprostadil. A 20-gauge needle was inserted into the deep dorsal penile vein under local anesthesia. All patient received a pelvic venogram prior to and after the embolization. Aethoxysclerol 3% as sclerosing agent was injected after air-block with valsalva manoeuvre. Success was defined as the ability to achieve vaginal insertion without the aid of any drugs, vasoactive injections, penile prosthesis, or vacuum device. Furthermore, the pre- and post-therapeutical IIEF score (International Index of Erectile Function) was assessed. Complete follow-up data was available on 55 out of 69 patients. RESULTS: Patients mean age was 57.6 years. The overall success rate was 63.6% at a mean follow-up of 9.2 months (Range 3 to 12 months). The actual IIEF score improved from 38 to 72 points (means). 35 patients reported erections sufficient for vaginal insertion without the use of any drug or additional device. Partial improvement was seen in 8 further patients. No serious complications occurred. CONCLUSIONS: Venoablation using aethoxysklerol in aero-block technique is an effective, minimally invasive, and cost-effective therapy for patients with erectile dysfunction due to venous leakage. This new method may also be a feasible treatment option for patients with contra-indications against PDE5inhibitors. Eur Urol Suppl 2015; 14(8): e1452