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Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak

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) caver...

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Autores principales: Hoppe, Hanno, Hirschle, Dominique, Schumacher, Martin Christian, Schönhofen, Heinz, Glenck, Michael, Kalka, Christoph, Willenberg, Torsten, Sixt, Sebastian, Müller, Dominik, Gutzeit, Andreas, Christe, Andreas, Mohan, Vignes, Diehm, Nicolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656380/
https://www.ncbi.nlm.nih.gov/pubmed/37975993
http://dx.doi.org/10.1186/s42155-023-00403-9
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author Hoppe, Hanno
Hirschle, Dominique
Schumacher, Martin Christian
Schönhofen, Heinz
Glenck, Michael
Kalka, Christoph
Willenberg, Torsten
Sixt, Sebastian
Müller, Dominik
Gutzeit, Andreas
Christe, Andreas
Mohan, Vignes
Diehm, Nicolas
author_facet Hoppe, Hanno
Hirschle, Dominique
Schumacher, Martin Christian
Schönhofen, Heinz
Glenck, Michael
Kalka, Christoph
Willenberg, Torsten
Sixt, Sebastian
Müller, Dominik
Gutzeit, Andreas
Christe, Andreas
Mohan, Vignes
Diehm, Nicolas
author_sort Hoppe, Hanno
collection PubMed
description 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.
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spelling pubmed-106563802023-11-17 Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak Hoppe, Hanno Hirschle, Dominique Schumacher, Martin Christian Schönhofen, Heinz Glenck, Michael Kalka, Christoph Willenberg, Torsten Sixt, Sebastian Müller, Dominik Gutzeit, Andreas Christe, Andreas Mohan, Vignes Diehm, Nicolas CVIR Endovasc Review Article 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. Springer International Publishing 2023-11-17 /pmc/articles/PMC10656380/ /pubmed/37975993 http://dx.doi.org/10.1186/s42155-023-00403-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review Article
Hoppe, Hanno
Hirschle, Dominique
Schumacher, Martin Christian
Schönhofen, Heinz
Glenck, Michael
Kalka, Christoph
Willenberg, Torsten
Sixt, Sebastian
Müller, Dominik
Gutzeit, Andreas
Christe, Andreas
Mohan, Vignes
Diehm, Nicolas
Erectile dysfunction: role of computed tomography cavernosography in the diagnosis and treatment planning of venous leak
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 Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656380/
https://www.ncbi.nlm.nih.gov/pubmed/37975993
http://dx.doi.org/10.1186/s42155-023-00403-9
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