Etiology and classification of venous impotence

The etiology and classification of venous impotence according to the literature, vascular impotence is the highest incidence of organic impotence, vascular impotence can be further divided into arterial, venous, arteriovenous mixed three types, among which venous impotence is the most concerned, which accounts for the vast majority of vascular impotence. Most venous leaks are spontaneous, and the incidence increases with age. The cause of venous impotence has not yet been clarified, and it is speculated that it can include the following: 1. Excessive veins exist or produce too many veins in the penile sponge. Excessive veins may be congenital (the patient will be primary impotence) or acquired (secondary impotence). Congenital or acquired valvular insufficiency in vein; scar in vein; elasticity of vein decreases with age. 2. The white membrane becomes sparse and weak due to degeneration, resulting in insufficient compression of the ductal vein and subalbugmental vein, which may be caused by aging, sclerosis or many unknown causes. There may also be congenital or acquired leaks in the albino. For example, the abnormal changes of neurotransmitter receptors in the white membrane of the corpus cavernosum in elderly men make the function of elastic fibers disordered, which can lead to weak erection and become one of the causes of venous leakage. 3. The direct injury of cavernous smooth muscle squirting dildo , such as atrophy or fibrosis, can prevent the full expansion of blood sinuses and the compression of venules. These loss of compliance may be caused by injuries, atrophy or degeneration that are common in patients with diabetes or arteriosclerosis. The elasticity of the cavernous tissue can also be weakened by the increase of collagen fibers. 4. Inadequate or inappropriate release of neurotransmitters, resulting in poor relaxation of blood sinuses and failure of vein occlusion. The reason may be psychogenic or neurogenic, or it may be that smoking inhales too much nicotine, which increases adrenergic activity, stimulates alpha receptors and increases vascular tension. 5, no matter it is congenital or acquired, the venous communicating branch between the corpus cavernosum of the penis and the cavernous body of the urethra can cause impotence. Acquired may be caused by trauma, or it may be caused by puncture during the treatment of abnormal erection. No matter what kind of situation mentioned above, venous impotence is abnormal in the venous system of the corpus cavernosum of the penis, so that the pressure in the cavernous body is less than 80 mm Hg, so it can not effectively reduce venous reflux in the process of erection, and a large amount of blood leaks from the vein, so that the erection of the penis is not firm or the time of erection is short. From the distribution and degree of penile venous leakage, it can be divided into the following types: 1. Deep dorsal venous leakage of penis: the deep dorsal vein of penis, the venous plexus around prostate and the lateral venous plexus of bladder can be seen by radiography. 2. Penile cavernous glans leakage: penile glans and urethral cavernous bodies can be seen by radiography. 3. Cavernous vein leakage: the foot of the penis or the deep vein of the penis and the internal pudendal vein can be seen by radiography. 4. Superficial venous leakage: thick superficial veins can be seen converging into the great saphenous vein, femoral vein or spermatic vein and spermatic venous plexus. 5. Complex venous leakage: two or more kinds of venous leakage exist at the same time. Among the types of 1Mel 4, deep dorsal vein leakage of penis is the most common, accounting for about 85%, but simple deep dorsal vein leakage accounts for only 1x4 of them rose vibrator , and the other 3amp 4 are complex venous leakage. This means that if we do not carefully classify venous impotence and adopt different surgical methods for different types of venous leakage, we will not be able to achieve a better curative effect. In the past, the ideal effect of ligation of deep dorsal vein alone was also the inevitable result of people's understanding of superficiality at that time. Ligation is at best a palliative rather than a permanent cure, so it is difficult to ensure the long-term effect of the operation no matter how thorough the ligation is. Patients should be carefully selected before operation, full preoperative evaluation, thorough understanding of venous anatomy and skilled surgical techniques can ensure a high success rate of operation. From the above etiological mechanism analysis, for the first and fifth mechanism of venous impotence, whether it is to repair leakage or ligate too many veins are expected to achieve better surgical results. Unless the condition is too mild to recommend chemical prostheses for drug injection to these patients, the drug will quickly enter the body, causing systemic drug reactions. For the second and third kinds of venous impotence, unless the lesion is very limited horse cock dildo , it is not appropriate to carry out vascular surgery. Prosthesis implantation is a more appropriate choice. As for the treatment of the fourth kind of venous impotence my old ass , the treatment of patients with venous impotence should be highly individualized: psychotherapy should be selected and arranged for patients with severe psychological factors, and low-dose injection of vasoactive drugs in penile sponge can be used for neurotic patients. It should be noted that this occult venous leakage is not uncommon, as contrast media leakage can also be seen in some men with normal erectile ability. Their clinical significance remains to be further studied and investigated.
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