The indication for venous surgery in the treatment of erectile dysfunction has been reduced as evidence of unsatisfactory long - term results have emerged. The short and long - term results of venous surgery were assessed in patients with veno - occlusive dysfunction who were selected in the basis of thorough diagnostic criteria. All of patients in this study were unresponsive to maximum recommended does of intracavemous injection therapy. All of patients provided a detailed medical and sexual history underwent a complete physical examination. Douplex Doupler US of penile arteries and cavernosometry and cavernosograpy was also performed, and serum testosterone concentration was determined. The Study group included 16 impotent men and from 27 to 48 (average, 37 years) who underwent complex penile venous surgery. Of the 16 patients, 15 (93.7%) had normal erections within one year after surgery but one patient needed to injection (20 mg papaverine) for erection. At long - term follow up, I Tom 13 to 60 months (average 60 months) spontaneous erection were demonstrated in 11 patients (68.7%). It would appear that the short and long-term complex venous surgery can result in more successful outcomes, provided that it performs in case of pure and high - degree veno - occlusive dysfunction as well as careful selection of patients.

Erectile dysfunction is an important problem for men and their families which has an organic cause in about 50 percent of cases. When there is a vasculogenic etiology for this defect, radilogic assessment is unavoidable. Cavernosometry and cavernosography are ultimate procedures for diagnosis of venous leakage. There is no reliable data about these defects in Iran. The objective of this study was to determine the rate of venous leakage in patients with erectile dysfunction by Pharmarco-Cavernosometry and Cavernosography. In this case serirs study, 100 patient with erectile dysfunction who referred to radologic ward in sina hospital was selected and Pharmarco-Cavernosometry and Cavernosography were conducted for them. In Cavernosometry, after injection of Prstaglandin E1 and salin normal infusion into corpus covernosum, the pressure was determined. In cavernosography, diluted Omnipaque was injected and venous leaking and other defects were recognized. Myoclinic’s criteria was use for analysis of the results. Mean age of patients was 35.6±11.6. Most of the cases were in 20 to 40 age group. The frequency of venous leakage based on 50 mmHg reduction in pressure (from 150 mmHg), after 30 seconds discountinuance of normal salin infusion was 90 percent. This figure based on the ratio of Maintenance Flow Rate of Induced Flow Rate, was more than 92 percent. The frequency of venous leakage according to Cavernosography was 89 percent. There were no significant side effects in any of cases induced by procedures. The results of study, shows the high prevalence of venous leakage in patients referring for erectile dysfunction.

Resin-based composite restorative materials have a substantial share in dental treatments. Their esthetic has made them patients’ first choice as restorative materials. Marginal leakage is one of their problems which leads to recurrent caries and post-operative hypersensitivity. Our aim was to evaluate the theoretical and clinical methods that have been proposed in the dental literature. Around 50 articles from Pubmed, SCOPUS and google scholar were selected and categorized in 4 groups based on the selected keywords. All the studies discussed in this paper have emphasized that there is no way to eliminate the microleakage but it can be reduced by means of some approaches. On the other hand, due to the multifactorial nature and difference of oral environment and laboratory conditions, there isn’ t any certain way to define precisely. It seems that there is an absolute need for more research in this field to make the relation of theoretical results and clinical findings possible.

Introduction: Our aim was to investigate the association of corporeal cavernosal pathology with venoocclusive erectile dysfunction (ED) and whether preoperative corporeal biopsy can help predict postoperative results. Materials and Methods: A total of 36 patients with venoocclusive ED underwent corporeal cavernosal biopsy and venous ligation. Preoperative assessment included complete physical examination, international index of erectile dysfunction (IIEF) scoring, nocturnal penile tumescence, penile Doppler ultrasonography, cavernosography, and, if needed, cavernosometry. Three months after surgery, all patient parameters were reevaluated and compared with the preoperative results. Biopsy results of 43 patients with penile fracture were used for controls. Results: The mean follow-up was 49.0 ± 24.1 months. The mean age of the patients with ED was 32.1 ± 8.6 years. Venous leakage was clearly revealed by cavernosography in all patients, preoperatively. The IIEF score and peak systolic velocity of the cavernosal artery in the patients did not differ postoperatively. The mean end diastolic velocity (EDV), however, decreased from 11.0 cm/s to 5.1 cm/s (P = .023). Only 2 patients had satisfactory penile rigidity after venous ligation, 2 were helped by intracorporeal injection to achieve full rigidity, and 1 used oral sildenafil to achieve full rigidity. Pathologically, 23 patients had a slight decrease of cavernosal smooth muscle cells, while in 9 patients, the cavernosal smooth muscles were markedly decreased and replaced by collagen fibers. Four patients had normal histologies, and all responded either partially or completely to surgical therapy. In the control group, 41 of 43 patients had a normal histologies, and 2 had a slight decrease of smooth muscle cell mass. Conclusion: Decreased cavernosal smooth muscle mass may impair erectile function. Its association with venoocclusive ED may be a poor prognostic factor of the outcome of surgical therapy. For the preoperative evaluation of patients, we propose cavernosal biopsy.

Penile venous ligation (PVL) is one of the reatments of erecticle insufficiency. In this review, 16 patients with erecticle dysfunction due to corporeal venous occlusive dysfunction were treated by PVL.patients’ age ranged from 27 to 48 years (mean 37) and the duration of their impotency was between 24 to 96 months (mean 60). Follow-up ranged from 13 to 60 months (mean 36.5). 11 patients (68.7%) recovered completely and had erections to permit unaided coitus. In 5 patients, recovery was temporary for less than one year (one year patient 8 months and others less than 6 months) one of them had sufficient erections and coitus with intracavernosal injection at 20gm papaverine postoperatively. Viewing this data, it seems that minimum follow-up period should be longer than one year and that PVL is an acceptable method for erecticle dysfunction due to venous leakage.

Introduction & Objective: Chronic venous disease of lower limb is one of the most common diseases. The primary treatment for chronic venous disease is non-surgical. Surgical treatment used in cases where endovascular techniques fail, or endovascular option is not possible. The grafts used in the venous system are much more likely to develop thrombosis. ePTFE is the best choice for replacing large veins with prosthetic grafts. In this study patients with chronic venous insufficiency and active ulcer (C6) in the field of iliac and femoral vein occlusion that were candidate for venous bypass and in these patients, the use of autologous vein was not possible and instead of using of ePTFE, The harvested iliac vein was used as a conduit. Materials & Methods: This is a case study in which patients with chronic venous insufficiency and active wound (C6) in the field of iliac and femoral vein occlusion who are candidates for venous bypass surgery while the use of autologous vein was not possible and Instead of using PTEF, the iliac vein is used as a conduit. Five patients were enrolled in intravenous bypass with allograft of brain-dead patients and were evaluated for graft patency, wound healing, limb edema and patient satisfaction within one year. Results: The patency rate graft after one year was two out of five cases (40%), while the wound in four patients after one year had complete healing (80%). Two patients had no edema and mild edema (40%) and three had moderate edema. There was also relative satisfaction in patients with thrombosed grafts. Although three of the grafts were thrombosed in the sixth month, the wound in these patients was completely healed in two cases and one was significantly healed, indicating that a six-month graft patency was sufficient to heal the wound. Conclusions: Complete and significant recovery of patients, even in cases that were present after six months of stenosis, indicated that the initial opening of the wound for six months is sufficient for wound healing. Also, due to wound healing, edema and patient satisfaction, the use of this type of allograft is recommended, especially in infectious patients. However, due to the lack of a control group, it is recommended that a larger study be performed if a sufficient number of patients are available.