The excessive blood outflow from the corpora cavernosa during erection ('venous leakage') is a frequent cause of impotence. Dynamic cavernosography, a recent technique, is able to both evaluate such venous leakage and detect the veins concerned. After a critical review of the literature and on the basis of their own experience (64 cases), the authors suggest a 2-phase method. A conventional cavernosography is performed and flows of physiological solution necessary to induce and maintain an artificial erection are separately measured. Subsequently, only the patients with increased flow rates undergo a second angiography of the corpora cavernosa and drainage paths, after being given and intracavernous injection of papaverine. A simple, more rational and less invasive examination can thus be performed. All useful parameters can nevertheless be examined when surgical/radio-interventionist treatment is considered.
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