How is cavernosal perfusion performed?

Cavernosal perfusion is usually used to diagnose erectile dysfunction. The operation process includes local anesthesia, puncture injection, pressure monitoring and other steps. The surgical process mainly includes five key links: preoperative assessment, disinfection preparation, drug injection, perfusion observation, and postoperative treatment.

1. Preoperative evaluation:

The doctor needs to confirm that the patient has no bleeding tendency or local infection, and understand the history of drug allergy through consultation. Penile blood flow ultrasonography is routinely performed to rule out vascular lesions. In some cases, anticoagulant drugs need to be stopped in advance to avoid the risk of intraoperative bleeding.

2. Disinfection preparation:

The patient lies supine and a tourniquet is applied to the base of the penis. Use iodophor solution to disinfect the penile skin three times and lay a sterile drape. The puncture point is mostly chosen at the middle part of the dorsal side of the penis, avoiding visible blood vessels, and is anesthetized by local injection of lidocaine.

3. Drug injection:

A fine needle is used to inject vasoactive drugs into the cavernous body, commonly used prostaglandin E1 or papaverine. After injection, massage the puncture point to promote drug diffusion, remove the tourniquet and observe the erectile response. Drug doses were adjusted based on age and medical history, with a low-dose test being used for the first injection.

4. Perfusion observation:

Connect a pressure sensor to monitor intracavernous pressure. Normal erection pressure must exceed 80mmHg. Normal saline was continuously infused through the perfusion pump, and the flow rate threshold for inducing erection was recorded. Color Doppler examination was performed simultaneously to evaluate arterial congestion and venous closure function.

5. Postoperative treatment:

After removing the needle, apply pressure on the puncture point for 5 minutes to prevent hematoma, and apply a dressing for 24 hours. Inform patients that persistent erection or subcutaneous congestion may occur, and that priapism lasting more than 4 hours requires emergency treatment. Avoid strenuous exercise and sex for a week.

It is recommended to keep the puncture site dry and clean after surgery, and apply cold compress to reduce swelling within 48 hours. Avoid wearing tight underwear to compress the penis on a daily basis, and observe whether the skin turns purple or the pain worsens. The diet should be light and rich in vitamin C to promote blood vessel repair, and recheck after two weeks to evaluate the recovery of cavernous body function. Patients with diabetes or cardiovascular disease need to strengthen blood sugar and blood pressure monitoring, and if necessary, combine oral phosphodiesterase inhibitors to improve erectile function.