陰莖靜脈閉鎖不全之患者無益串線圈治療

許耕榕 ¹、謝宗穎 ²、鍾卓興 ³、陳明村 ⁴、闕士傑 ²

¹ 埔里基醫院 顯微性功能重建暨研究中心 ; ² 臺灣大學附醫院泌尿部; ³ 臺北醫學大學萬芳醫院泌科; ⁴ 書田泌尿科眼科診所

Chain coil is questionable in treating patients with penile veno-Occlusive dysfunction

Geng-Long Hsu^1,2,4, Chung-Yi Hsieh², Cho-Hsing Chung³, Ming-Tsun Chen⁴, Jeff SC Chueh²

1 Puli Christian Hospital, Microsurgical Potency Reconstruction and Research Center, Puli

Township, Nantou, Taiwan

² Department of Urology, National Taiwan University Hospital, Taipei, Taiwan

³ Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

⁴ Microsurgical Potency Reconstruction and Research Center, Hsu’s Andrology and Shu-Tien

Urology Ophthalmology Clinic, Taipei, Taiwan

Purpose: In a variety of treatments for male impotence primarily resulting from penile veno-occlusive dysfunction, older term venous leakage, single coil (SC) embolization was introduced in the 1980s and was once popularized. A recent study suggested that coil embolization is not justified for this elusive condition, as a single coil may migrate out of the right ventricle. Nevertheless, the single coil appears to have evolved into the chain coil (CC) design. We sought to report on our clinical observations about this issue. 

Materials and Methods: From 2013 to 2025, refractory impotence prompted nine men to seek penile venous stripping surgery (PVSS), although 11 episodes were performed elsewhere internationally. They were allocated to groups: SC (n = 5) and CC (n = 4). All received dual cavernosography, in which erection-related veins were anatomically demonstrated, and VODr was confirmed again. On an ambulatory strategy, PVS entailed the venous stripping of one deep dorsal vein and a pair of cavernosal veins after every offensive emissary was firmly fixed closest to the outer tunica using 6-0 nylon. Subsequently, the two pairs of para-arterial veins were segmentally ligated. The abridged 5-item version of the International Index of Erectile Function (IIEF-5) score system and the Erection Hardness Scale (EHS) were used preoperatively, and postoperative follow-up was conducted via the internet annually.

Results: In the SC group (n=5), inserted coils were scattered along the erection-related veins, including the deep dorsal veins (n=4), periprostatic plexus (n=5), iliac vein (n=5), right pulmonary artery (n=2), left pulmonary artery (n=2), and right ventricle (n=1), ended with coil migration out of the right ventricle. PVS has made some improvements in the IIEF-5 score and EHS scale. In the CC group (n=4), there was no benefit of erectile restoration after CC therapy, although no coil travelling radiographically; amazingly, however, erection restoration was unexceptionally attained from 2 weeks to two months after PVS on an ambulatory basis.