Novel pilot films providing indispensable information in pharmaco-cavernosography

BACKGROUND Conventional pharmaco-cavernosography provides little information on penile venous anatomy, although it is indispensible in documenting veno-occlusive erectile dysfunction (ED). We propose an innovative method, which may provide additional insight into the penile venous structure. METHODS From July 2010 to November 2012, 96 impotent men, aged 20 to 75 years, underwent this method of pharmaco-cavernosography in which two sets of 60 mL of 50% omnipaque solution administered intracavernously by themselves. The first set of pilot cavernosograms was taken at intervals of five, ten, twenty and thirty seconds after the commencement of the injection. The second set of cavernosograms was taken in the same intervals within 30 minutes following the pilot set, preceded by the injection of 20 µg prostaglandin E1 (PGE1). Analysis was conducted on the drainage veins including deep dorsal vein (DDV), cavernosal veins (CVs) and para-arterial veins (PAVs) accordingly. The veins demonstrated in the pilot cavernosograms, and the second set, were compared in terms of venous numbers and presentation percentage. RESULTS There was a statistically significant difference (P<0.001) between the total number of independent venous drainage channels and the presentation percentage of DDV, CVs and PAVs observed in the pilot cavernosograms, and those in second set (4.5 vs. 2.1; 97.47%, 60.33%, and 38.91% vs. 57.06%, 29.34%, and 19.08%, respectively). CONCLUSIONS Compared with conventional pharmaco-cavernosography methods, pilot cavernosograms are readily able to show detailed penile venous anatomy. It is therefore may be concluded that pilot cavernosograms is a valuable addition to conventional protocols of pharmaco-cavernosography.