What is it about?
This article describes a serious complication that occurred after a man received coil embolization — a procedure sometimes used to treat penile veno‑occlusive dysfunction (VOD). In this condition, blood leaks out of the penis too quickly to maintain an erection. The report follows four men who had undergone a total of six coil embolization procedures at other hospitals. Instead of staying in place, the coils migrated uncontrollably through the venous system. The misplaced coils were found in: The deep dorsal vein the periprostatic plexus the iliac vein the right pulmonary artery the left pulmonary artery and in one case, the right ventricle of the heart One patient — a 40‑year‑old construction worker — experienced the most severe complication: 18 months after the procedure, a coil perforated his right ventricle and diaphragm. The key message of the article is that coil embolization may not be safe or effective for treating venous leak erectile dysfunction. The authors conclude that the technique is unreliable and can lead to dangerous, life‑threatening complications.
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Why is it important?
1. It reveals a dangerous complication that is rarely discussed Coil embolization is often promoted as a “safe and effective” treatment for venous‑leak erectile dysfunction. This report shows that coils can migrate uncontrollably through the venous system — even reaching the lungs and the heart. One coil even perforated the right ventricle and diaphragm 18 months after the procedure. This is not a minor complication — it is life‑threatening. 2. It challenges the belief that coil embolization is reliable All four men in the report had no lasting improvement in erectile function despite undergoing six embolization procedures. The authors conclude that the safety and effectiveness of coil embolization for treating veno‑occlusive dysfunction (VOD) remain unreliable. This directly contradicts the way the procedure is often marketed. 3. It highlights the need for better treatment standards Because VOD is a real, physical condition, patients deserve treatments that are: anatomically sound evidence‑based safe in the long term This case report shows that coil embolization may not meet those standards. 4. It protects patients by raising awareness Many men with erectile dysfunction are desperate for solutions and may be vulnerable to aggressive marketing. This report provides critical safety information that can help patients and clinicians make informed decisions. 5. It encourages more rigorous research The findings suggest that the field needs: Better diagnostic accuracy safer treatment strategies long‑term outcome data This case report is a reminder that not all minimally invasive procedures are risk‑free.
Perspectives
This case report warns clinicians that coil embolization for venous leak erectile dysfunction may not be as safe as previously believed. The uncontrolled migration of coils into the lungs and even the right ventricle shows that the procedure can create serious, unexpected complications. Clinicians should reconsider whether this technique is appropriate for treating VOD. Patient Safety Perspective The most important message is patient safety. One man experienced a coil that perforated his heart and diaphragm 18 months after the procedure. This underscores the need for extreme caution when offering treatments involving permanent implants in the venous system. Scientific Perspective The report challenges the assumption that coil embolization is “effective and safe.” All four men in the study had no sustained improvement in erectile function despite undergoing six embolization procedures. The findings suggest that the technique may not reliably correct the underlying physiology of VOD. Health‑Policy Perspective Because coil embolization is sometimes marketed aggressively as a minimally invasive solution for venous‑leak ED, this report raises important questions about regulation, oversight, and informed consent. Patients should be fully aware of the potential for severe complications. Research Perspective This case report underscores the need for better‑designed studies and safer, anatomy‑guided approaches to treating VOD. It also highlights the importance of long‑term follow‑up — complications may appear months or years after the procedure. Quality‑of‑Life Perspective Men seeking treatment for erectile dysfunction are often vulnerable and highly motivated to find solutions. When a treatment not only fails but causes life‑threatening harm, the emotional and psychological impact can be profound. This report emphasizes the need for treatments that are both effective and safe.
Dr. Geng Long Hsu
Read the Original
This page is a summary of: A case report of right cardiac ventricle perforation by uncontrolled embolization coil inserted for treating penile veno-occlusive dysfunction, Urology Case Reports, September 2022, Elsevier,
DOI: 10.1016/j.eucr.2022.102166.
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