The Effect of Electrocoagulation on the Sinusoids in the Human Penis

Abstract

We give an overview of patients who have undergone removal of the deep dorsal vein for venous grafting in treating Peyronie disease with or without a Bovie effect. From June 1998 to May 2002, 23 men received grafting of the deep dorsal vein for morphologic correction. Among them, 7 men underwent electrocoagulation treatment of bleeders per surgeons' customary practice during the entire procedure and were categorized as the electrocoagulation group. Sixteen patients received simple ligation of bleeding stumps, with 6-0 nylon sutures, and were classified as the ligation group. All were followed for satisfaction of penile morphology and assessed by the abridged 5-item version of the international index of erectile function (IIEF-5) scoring for erectile capability. In the electrocoagulation group, a mean preoperative IIEF-5 score of 22.5 +/- 1.6 decreased to a mean postoperative IIEF-5 score of 17.9 +/- 4.1. Among them 2 men (28.6%) had sustained postoperative infection. Follow-up cavernosograms showing relatively poor filling are commensurate with intracavernosal fibrosis. In the ligation group, however, the mean IIEF-5 score was 22.3 +/- 1.9 preoperative and 22.9 +/- 2.0 postoperative. Although there was no statistical significance between the 2 groups in preoperative IIEF scores, there was a significant difference between groups postoperatively. Application of electrocoagulation appears to be disadvantageous in preserving erectile tissues. A Bovie effect should be avoided in this erectile organ in order to preserve erectile capability and avoid infection.

Histopathological effects of fibrin glue on penile fracture in a rat model

“…Roberto, et al showed that a combination of both suture an brin glue techniques provided better conditions for nerve regeneration than sutures alone a er siatic nerve transectionin a rat model [27]. In previous studies of experimentally induced penile fracture, agents such as Ankaferd Blood Stopper (ABS) and electrocogulation have been used,but these agents did not prevent the development of brosis in erectile tissues [28,29].…”

Formulas for determining the dimensions of venous graft required for penile curvature correction

“…Adequate compression to the proximal portion of the tunical defect is delivered by the assistant's hand to control bleeding, as substantial bleeding may otherwise cause the operation to be aborted. The use of Bovie electrocautery may be irreversibly hazardous to the delicate sinusoids due to thermal injury (Hsu et al, 2004). This is particularly true if the attending surgeons use the surgical principles learned during their training period, which are inappropriate for this procedure.…”

Surgical niche for the treatment of erectile dysfunction

“…). With electrocautery spared to avoid destruction of tissue, ligation of the penile veins and hemostasis is achieved with interrupted 6‐0 nylon sutures throughout the entire procedure . Anticoagulants, usually aspirin, can be reinstituted as early as 1 week postoperatively.…”