Combined phlebectomy in androgenital form of varicosity veins of small pelvis

Abstract

The study objective is to demonstrate the effectiveness of combined phlebectomy of varicose veins of the penis and spermatic veins in the treatment of venous erectile dysfunction of the distal type in combination with varicocele as an androgenital manifestation of small pelvic varicose disease; to demonstrate the potency of combined phlebectomy of varicose veins of the penis and spermatic veins in the treatment of venous penis of the distal type in combination with varicocele, as an androgenital manifestation of small pelvic varicose disease in men.Materials and methods. Combined phlebectomies (n = 5) were performed in patients with androgenital form of varicose small pelvic, clinically manifested by erectile dysfunction, varicose veins, varicocele.Results. Preoperative complex examination of patients included multispiral computer, magnetic resonance angio andpharmacocavernosog-raphy with ultrasonic duplex scanning of the penis, scrotum, prostatic venous plexus allowed verifying varicose disease of the small pelvic, clinically manifested by erectile, dysmorphophobic disorders in combination with varicocele. Combined phlebectomy superficial veins of the penis in combination with the operation of Marmara (phlebectomy veins of spermatic cord) with blockage of outflow into the sapheno-femo-ral anastomosis gave a positive result in all cases. The international index of erectile function increasedfrom 12 ± 2 points before the operation to 21 ± 1 pointspostoperativly (p <0.05).Conclusion. Blocking of superficial and deep venous systems of the penis by naked circumscision with phlebectomy of the superficial vein of the penis, bandaging of the retroglandular plexus in the area of the coronary sulcus of the penis, as well as high ligation in the inguinal-femoral region of the superficial vein of the penis in combination with phlebectomy of the spermatic veins (operation Marmara) allow to restore hemodynamic balance between arterial inflow and venous outflow to penis and achievement of adequate erection, sufficient for vaginal penetration.

Keywords

• varicose disease of the penis
• erectile dysfunction
• varicocele
• phlebectomy