When Venous Leak Surgery "Fails": Did the Veins Grow Back, or Were They Never Removed?

What is it about?

This article investigates why Penile Venous Stripping Surgery (PVSS) for erectile dysfunction sometimes doesn't yield a perfect result. The Problem: Some patients undergo surgery to stop venous leakage but still experience ED symptoms afterward. Critics often use this to claim venous surgery "doesn't work." The Investigation: The article asks the critical question: Did the veins grow back after surgery ("recurrent"), or did the original surgeon miss tiny, complex veins because they didn't fully understand the anatomy ("residual")? The Conclusion: Based on deep anatomical study, the failure is almost always due to residual veins—veins that were missed during the first operation.Defending the Procedure: It proves that the concept of venous surgery is sound; the failures are usually due to imperfect execution. Hope for Revision: If the problem is "residual" (missed) veins, it means the patient can be helped with a revision surgery by an expert who knows where to look. It's not a hopeless situation. Raising Surgical Standards: It emphasizes that this is painstaking microsurgery requiring profound anatomical knowledge, not a simple procedure any urologist can perform easily.

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Photo by gomi on Unsplash

Photo by gomi on Unsplash

Why is it important?

Defending the Procedure: It proves that the concept of venous surgery is sound; the failures are usually due to imperfect execution. Hope for Revision: If the problem is "residual" (missed) veins, it means the patient can be helped with a revision surgery by an expert who knows where to look. It's not a hopeless situation. Raising Surgical Standards: It emphasizes that this is painstaking microsurgery requiring profound anatomical knowledge, not a simple procedure any urologist can perform easily.

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