Penile venous insufficiency surgery is a surgical treatment method that can be applied to men experiencing erectile dysfunction due to venous leakage in the penis. The inability or reduced ability of the veins in the penis to function properly causes insufficient erection and loss of erection within a short time. In these patients, a highly effective and permanent alternative solution is offered by surgically closing the venous leak points at the root and deep points of the penis (deep dorsal vein ligation and closure of the deep penile veins) and, at the same time, applying stem cell (SVF) therapy to the spongy structures within the penis. Approximately one month after surgery, penile regeneration support is enhanced through ESWT (shock wave therapy) and plasma injection applications, which are continued in the clinic setting, thus completing the second phase of treatment.
When Is Penile Venous Insufficiency Surgery Performed?
- This procedure can be applied to patients diagnosed with mild or moderate venous insufficiency (venous leakage) on penile color Doppler ultrasonography.
- It is suitable for men who continue to experience erectile dysfunction due to venous leakage despite medical or minimally invasive treatments.
- It is best suited for patients in good general health, with partially preserved penile arterial structure, controlled diabetes, and ideally those who have quit smoking.
- For patients diagnosed with venous insufficiency who do not wish to undergo penile prosthesis implantation (“penile implant surgery”), it can serve as an alternative treatment option.
How Is Penile Venous Insufficiency Surgery Performed?
- The operation is a microsurgical procedure performed under spinal or general anesthesia. It typically lasts about 1.5–2 hours and is often performed on an outpatient basis.
- The procedure begins with small incisions at the base of the penis, allowing access to the deep venous structures. The veins responsible for venous leakage are identified during this step.
- The malfunctioning veins are permanently closed using special microsurgical suturing techniques, effectively eliminating or minimizing venous leakage.
- In the final stage of the surgery, a small amount of subcutaneous fat tissue is aspirated from the lower abdominal wall using a micro-aspiration technique. Stem cell-rich SVF (stromal vascular fraction) is isolated from this fat and injected into the spongy erectile tissues of the penis. This enhances the ability of the cavernosal tissues to retain blood more effectively during erection.
- After a few hours of observation, the patient is discharged the same day and can usually return to normal activities the following day.
Advantages of Penile Venous Insufficiency Surgery
- Permanently resolves venous leakage-related erectile dysfunction.
- May be combined with supportive therapies such as ESWT (shockwave therapy) or plasma injections to enhance treatment success.
- Preserves penile nerves and arterial structures, maintaining the natural erectile mechanism—making it a viable alternative to penile prosthesis implantation.
- Offers a comfortable experience since hospitalization is not required, and patients can go home the same day.
- Can be safely performed under spinal anesthesia without the need for general anesthesia.
- Because only small incisions are made, post-operative scarring is minimal, and the aesthetic appearance is well preserved.
- The short recovery period allows patients to return to daily life the next day.
Postoperative Considerations
- Lifestyle modifications that support vascular health—such as quitting smoking, exercising regularly, and maintaining a healthy diet—are crucial for long-term success.
- After surgery, patients should continue with the second phase of the treatment protocol, including supportive in-office therapies such as ESWT and plasma injections.
Final Notes
Penile venous insufficiency surgery is a microsurgery-based procedure used to treat erectile dysfunction caused by venous leakage in the penile veins. It is suitable for a select group of patients and, when combined with follow-up therapies and positive lifestyle changes, offers an effective alternative for men who prefer not to undergo penile prosthesis implantation.
