Hsu et al reported on redo venous stripping for men with venous occlusive problems. The 16 patients in the study had undergone prior venous surgery that ended with penile deformities and no improvement in their erectile dysfunction (ED). The redo procedures lasted 5.2-8.5 hours and required approximately 125 ligations/ case. This procedure was similar to the vaso-occlusive technique that these authors used on men with ED without deformities (Hsu, 2006).Intuitively, this meticulous approach may be necessary to correct the fibrotic deformities of the penis, but the role of vaso-occlusive surgery for the treatment of ED remains confusing and worthy of further discussion. Hsu et al cited older reports of single-vein ligations (deep dorsal vein) and others involving multiple veins. However, the American Urological Association (AUA) guidelines for the treatment of organic erectile dysfunction noted that the outcome data were insufficient to recommend these procedures, and suggested that venous surgery was best suited for a research setting (Montague et al, 1996). Lewis (1990) presented a comprehensive review of the literature that confirmed variable results with venous ligation surgery, and Freedman et al (1993) noted that only 24% of men who had venous ligation surgery were capable of normal intercourse 1 year later.
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