Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak
Abstract Background Venous leak appears to be the most common cause of vasculogenic erectile dysfunction (ED), which can be treated with venous embolization. Traditionally, conventional cavernosography was used for the diagnosis and treatment planning of venous leak. Recently, computed tomography (C...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-11-01
|
| Series: | CVIR Endovascular |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42155-023-00403-9 |
| _version_ | 1797556173894844416 |
|---|---|
| author | Hanno Hoppe Dominique Hirschle Martin Christian Schumacher Heinz Schönhofen Michael Glenck Christoph Kalka Torsten Willenberg Sebastian Sixt Dominik Müller Andreas Gutzeit Andreas Christe Vignes Mohan Nicolas Diehm |
| author_facet | Hanno Hoppe Dominique Hirschle Martin Christian Schumacher Heinz Schönhofen Michael Glenck Christoph Kalka Torsten Willenberg Sebastian Sixt Dominik Müller Andreas Gutzeit Andreas Christe Vignes Mohan Nicolas Diehm |
| author_sort | Hanno Hoppe |
| collection | DOAJ |
| description | Abstract Background Venous leak appears to be the most common cause of vasculogenic erectile dysfunction (ED), which can be treated with venous embolization. Traditionally, conventional cavernosography was used for the diagnosis and treatment planning of venous leak. Recently, computed tomography (CT) cavernosography was introduced as a novel cross-sectional imaging method proposed to be advantageous over conventional cavernosography. We created a novel management algorithm for diagnosing venous leak including CT cavernosography as an imaging modality. In order to provide a broader basis for our management algorithm, a systematic literature review was conducted. Main body In this article we systematically review relevant literature on using CT cavernosography for the diagnosis and treatment planning in ED patients with venous leak following the PRISMA selection process. Nine full-text articles were included in the review and assigned a level of evidence grade (all grade II). Two studies (2/9) compared the results of conventional cavernosography with those of CT cavernosography which was superior for site-specific venous leak identification (19.4% vs. 100%, respectively). CT cavernosography is a more detailed imaging method that is faster to perform, exposes the patient to less radiation, and requires less contrast material. In one study (1/9), CT cavernosography was used for diagnostic purposes only. Eight studies (8/9) cover both, diagnostic imaging and treatment planning including embolization (1/9) and sclerotherapy (2/9) of venous leak in patients with venogenic ED. Three studies (3/9) describe anatomical venous leak classifications that were established based on CT cavernosography findings for accurate mapping of superficial and/or deep venous leak and identification of mixed or more complex forms of venous leak present in up to 84% of patients. In addition to treatment planning, one study (1/9) used CT cavernosography also for follow-up imaging post treatment. Conclusion CT cavernosography is superior to conventional cavernosography for diagnosis and treatment planning in patients with ED caused by venous leak (grade II levels of evidence). Consequently, CT cavernosography should be included in management algorithms for ED patients with suspected venous leak. |
| first_indexed | 2024-03-10T16:59:09Z |
| format | Article |
| id | doaj.art-9b7eef579e3a409ba8cdbee3ca300be5 |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-03-10T16:59:09Z |
| publishDate | 2023-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-9b7eef579e3a409ba8cdbee3ca300be52023-11-20T11:03:12ZengSpringerOpenCVIR Endovascular2520-89342023-11-016111010.1186/s42155-023-00403-9Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leakHanno Hoppe0Dominique Hirschle1Martin Christian Schumacher2Heinz Schönhofen3Michael Glenck4Christoph Kalka5Torsten Willenberg6Sebastian Sixt7Dominik Müller8Andreas Gutzeit9Andreas Christe10Vignes Mohan11Nicolas Diehm12University of BernUniversity of BernDepartment of Urology, Hirslanden Clinic AarauRadiology Center BadenMicrotherapy Center Bern, LindenhofspitalVascular Institute Central SwitzerlandUniversity of BernVascular Center BielVascular Center BielDepartment of Health Sciences and Medicine, University of LucerneDiagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University HospitalVascular Institute Central SwitzerlandUniversity of BernAbstract Background Venous leak appears to be the most common cause of vasculogenic erectile dysfunction (ED), which can be treated with venous embolization. Traditionally, conventional cavernosography was used for the diagnosis and treatment planning of venous leak. Recently, computed tomography (CT) cavernosography was introduced as a novel cross-sectional imaging method proposed to be advantageous over conventional cavernosography. We created a novel management algorithm for diagnosing venous leak including CT cavernosography as an imaging modality. In order to provide a broader basis for our management algorithm, a systematic literature review was conducted. Main body In this article we systematically review relevant literature on using CT cavernosography for the diagnosis and treatment planning in ED patients with venous leak following the PRISMA selection process. Nine full-text articles were included in the review and assigned a level of evidence grade (all grade II). Two studies (2/9) compared the results of conventional cavernosography with those of CT cavernosography which was superior for site-specific venous leak identification (19.4% vs. 100%, respectively). CT cavernosography is a more detailed imaging method that is faster to perform, exposes the patient to less radiation, and requires less contrast material. In one study (1/9), CT cavernosography was used for diagnostic purposes only. Eight studies (8/9) cover both, diagnostic imaging and treatment planning including embolization (1/9) and sclerotherapy (2/9) of venous leak in patients with venogenic ED. Three studies (3/9) describe anatomical venous leak classifications that were established based on CT cavernosography findings for accurate mapping of superficial and/or deep venous leak and identification of mixed or more complex forms of venous leak present in up to 84% of patients. In addition to treatment planning, one study (1/9) used CT cavernosography also for follow-up imaging post treatment. Conclusion CT cavernosography is superior to conventional cavernosography for diagnosis and treatment planning in patients with ED caused by venous leak (grade II levels of evidence). Consequently, CT cavernosography should be included in management algorithms for ED patients with suspected venous leak.https://doi.org/10.1186/s42155-023-00403-9Erectile dysfunctionVenous leakVenous incompetenceComputed tomography cavernosography |
| spellingShingle | Hanno Hoppe Dominique Hirschle Martin Christian Schumacher Heinz Schönhofen Michael Glenck Christoph Kalka Torsten Willenberg Sebastian Sixt Dominik Müller Andreas Gutzeit Andreas Christe Vignes Mohan Nicolas Diehm Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak CVIR Endovascular Erectile dysfunction Venous leak Venous incompetence Computed tomography cavernosography |
| title | Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak |
| title_full | Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak |
| title_fullStr | Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak |
| title_full_unstemmed | Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak |
| title_short | Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak |
| title_sort | erectile dysfunction role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak |
| topic | Erectile dysfunction Venous leak Venous incompetence Computed tomography cavernosography |
| url | https://doi.org/10.1186/s42155-023-00403-9 |
| work_keys_str_mv | AT hannohoppe erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT dominiquehirschle erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT martinchristianschumacher erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT heinzschonhofen erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT michaelglenck erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT christophkalka erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT torstenwillenberg erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT sebastiansixt erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT dominikmuller erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT andreasgutzeit erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT andreaschriste erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT vignesmohan erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak AT nicolasdiehm erectiledysfunctionroleofcomputedtomographycavernosographyinthediagnosisandtreatmentplanningofvenousleak |