Erectile dysfunction has a multifactorial etiology (age, diabetes, depression, hypertension, smoke, dyslipidemia, cardiovascular and neurologic diseases).
Normal erectile function depends on adequate arterial inflow as well as
venous outflow occlusion: penile rigidity depends on the correct balance between maximizing inflow of blood to corpora cavernosa while minimizing its outflow.
Relaxation of penile arterial tone causes blood to flow into the sinusoids of corpora cavernosa and it allows to exert pressure on penile veins against and within the tunica albuginea that mediates venous occlusion, resulting in penile engorgement and rigidity.
If the reason of impotence is either altered arterial blood flow or early venous outflow, the genesis is vasculogenic
Failure of adequate venous occlusion and presence of early venous leakage has been proposed as one of the most common causes of vasculogenic impotence in young patients
CVOD (CORPOREAL VENO-OCCLUSIVE DYSFUNCTION)
The necessity to identify eventual early venous leakages to establish the correct therapeutic management in each case:
1. Scleroembolization/surgical ligation of Deep Dorsal Vein
(Leakage from deep venous circle)
2. Intracavernous therapy/Surgical selective terapy/prosthesis implantation
(Leakage from superficial venous circle)
Cavernosography represents the historical diagnostic approach but it is time consuming, with less contrast and spatial resolution;
CT-Cavernosography, instead, is characterized by improved spatial and contrast resolution due to multiplanar reconstructions with better display of eventual venous leakages , and, in addition, can directly show the presence of other anatomical alterations such as fibrosis and calcifications