Venous leak embolization

 Venous leak is a disorder that affects erectile function in men. Lack of blood pressure in the veins responsible for erections makes it difficult or impossible to maintain a sufficiently firm erection.

Symptoms of venous leak include soft, short-lived erections that can lead to unsatisfactory sexual relations, in turn negatively impacting self-confidence and quality of life.

L'eVenous leak embolization is a minimally invasive procedure to restore the blood pressure necessary for normal erections. It consists in selectively blocking certain veins in order to redirect blood flow to the corpora cavernosa in the penis, thus enabling a more satisfactory erection.

Venous leak embolization is a cutting-edge minimally invasive procedure performed daily at the American Hospital of Paris by our experienced interventional radiologists. It is completely pain-free and does not leave a scar.

Procedure

The different steps of venous leak embolization at the American Hospital of Paris are described below:

1. Preparation: Prior to the procedure, our medical team will guide you through each step. All of your questions will be answered and you will be given detailed instructions on how to prepare.
2. Locale anesthesia: When you are ready, you will be escorted to the room where the procedure is to take place. A local anesthesia will be administered at the catheter insertion site, ensuring a completely pain-free operation.
3. Insertion of the catheter: Working under real-time fluoroscopy image guidance, the radiologist introduces a very thin catheter through a small incision in an artery. The catheter is then carefully guided to the veins responsible for the venous leak.
4. Embolization: Once the catheter is in place, microparticles or an embolic agent is injected into the targeted veins. These substances selectively block the veins in order to restore sufficient blood pressure to the corpora cavernosa in the penis, thus improving erectile function.
5. Surveillance and conclusion: Throughout the procedure, the medical team keeps a close watch on your state of health. When the procedure is completed, the catheter is removed and the incision is carefully sealed. Thanks to this technique, the procedure leaves no visible scar.

Venous leak embolization is performed on an outpatient basis. Following a short period of observation, patients can usually go home the same day. After you are discharged, our medical team is available 24/7 to answer any questions you may have.

Procedure duration

On average, the procedure lasts from one to two hours, depending on the complexity of each case.

Post-operative follow-up

Patients can resume their regular activities within a few days following the embolization. Most report a significant improvement in erectile function and quality of life after the procedure.

Cost and coverage

The cost of venous leak embolization is covered by Assurance Maladie, the French national health insurance, and by supplementary private insurers.

There could be a surcharge due to physicians’ fees and hospitalization expenses, but these charges are systematically determined with tact and moderation based on recommendations issued by the French Board of Physicians.

To ensure you are well-prepared for your procedure at the American Hospital of Paris, please follow the guidelines below:

• Bring the results of any previous medical exams
• Come for a consultation with our medical team before the procedure
• Inform our team of any medications you are currently taking
• Follow the fasting instructions prior to the procedure

The most recent studies on venous leak embolization show that it is a promising treatment for the associated symptoms and results in a significant improvement of erectile function. It could become a minimally invasive alternative to the commonly practiced surgical interventions.

In 2012, a study involving 29 patients analyzed how endovascular therapy could help men with erectile impotence caused by venous leak (1). All procedures were performed without any major or minor events (0% complication rate). The treatment was successful for 27 out of 29 patients (93.1%), with two unsuccessful procedures due to anatomical reasons. Overall clinical success was achieved in 24 out of 27 patients (88.8%), who reported that their situation had improved, with outcomes ranging from an absence of erection to a normal erection.

In 2014, a study on 18 patients evaluated the efficacy and safety of embolization to treat erectile dysfunction caused by venous leak (2). The results were positive: almost all patients reported an immediate improvement of their situation. According to follow-up data at 13 months, most participants experienced improved erections.

In 2019, a meta-analysis of 212 patients evaluated the safety and efficacy of endovascular therapy for erectile problems linked to veno-occlusive dysfunction or arterial insufficiency (3). The results showed the technical success of this therapy in 86% to 97% of cases. Regarding clinical results, around 59.5% of patients reported a partial or complete improvement of their situation. Complications were rare and minor, occurring in only 5.2% of cases.

References :

1.       https://pubmed.ncbi.nlm.nih.gov/23219214/

2.       https://pubmed.ncbi.nlm.nih.gov/24613267/

3.       https://pubmed.ncbi.nlm.nih.gov/31104902/

Venous leak embolization is a minimally invasive procedure with a low risk of complications:

• Infection: rare. The medical team takes all necessary measures to minimize this risk.
• Allergic reaction to the contrast agent: rare. Monitored and treated by the medical team.
• Hematoma and/or bleeding: generally diminish in the days following the procedure.
• Pain or discomfort at the surgical site: treated with pain relievers.
• Vascular complications: rare. Immediately managed by the medical team.

Your physician will answer all of your questions and provide the information necessary to make an informed decision about your treatment.