038 What is the Venous Drainage of the Penis After Radical Prostatectomy? An Observational Study Using CT Cavernosography

The penis is a hydraulic organ with erection dependent on an orderly progression of events, including neural stimulation, arterial inflow, and outflow occlusion. Problems with one or more of these processes will result in decreased erectile function. The primary venous outflow tract of the penis is via the dorsal venous complex (DVC), occlusion of which is primarily responsible for the outflow component of erectile function. The control of the DVC during radical prostatectomy (RP) as described by Reiner and Walsh played an integral role in the development of the nerve sparing and minimization of post-RP ED. However, post-RP ED remains an issue. Furthermore, venous ligation surgery for ED has long been abandoned due to development of collateral circulation and subsequent poor results. The implications of the “en mass” ligation of the DVC with regards to venous drainage and post-RP ED has not been described. We describe the venous drainage of the penis in men with ED refractory to PDE-5 after RP using CT cavernosography with 3D reconstruction.