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Cochin Hospital – Port-Royal · AP-HP · Paris Cité University
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Interventional Radiology Cochin
Cochin Hospital AP-HP AP-HP

Erectile Dysfunction — Venous Embolization

Interventional Radiology · Cochin Hospital AP-HP · Paris

️ ri.cch@aphp.fr +33 1 58 41 46 12
Interventional Radiology›Erectile Dysfunction — Venous Embolization
💙 Erectile dysfunction — Vascular cause

Penile Venous Embolization — Erectile Dysfunction

Venous leak treatment · Minimally invasive · Outpatient · Preserves sexual function

Our expertise

Our team treats vascular erectile dysfunction — specifically penile venous leak — by percutaneous venous embolization, in collaboration with urologists and andrologists.

What is vascular erectile dysfunction?

Erectile dysfunction (ED) can have a vascular cause: arterial (insufficient inflow) or venous (pathological outflow). In venous leak, blood flows normally into the corpora cavernosa but drains too rapidly through pathological veins, preventing the maintenance of a firm erection.

This penile venous insufficiency is one of the most common vascular causes of ED, particularly in younger men. It can follow pelvic trauma, priapism, or result from constitutional weakness of the tunica albuginea.

Confirming the diagnosis

  • Pharmacological penile Doppler ultrasound — reference investigation: assesses arterial inflow and venous resistance after intra-cavernous vasoactive injection
  • Penile MRI in selected cases
  • CT cavernogram (cavernoscanner) — performed BEFORE the procedure to map pathological retropubic veins

The embolization procedure

1

Dynamic cavernosography — mapping of the pathological venous drainage (corpus cavernosum → pudendal → iliac veins)

2

Dorsal penile vein or leg vein access — general anaesthesia (no jugular approach)

3

Selective occlusion of the draining veins — coils or biological glue — no sclerosing foam

4

Day case discharge — clinical follow-up at 3 months only — no Doppler, no routine imaging

Important: Penile venous embolization is indicated when a venous leak has been clearly identified by cavernosography. It is not appropriate for purely arterial or psychogenic erectile dysfunction.

At a glance — key figures

Penile venous leak (veno-occlusive dysfunction) is an organic cause of erectile dysfunction: venous blood escapes from the corpora cavernosa and prevents the erection from being maintained. Percutaneous embolization occludes these leaking veins through a catheter, without surgery or scarring.

CriterionData
Effect on erectionImprovement in 60–75% of cases in the medium term, in correctly selected patients
IndicationErectile dysfunction from venous leak confirmed on cavernosography/CT or Doppler ultrasound, resistant to PDE5 inhibitors
Anaesthesia / stayLocal anaesthesia — day case, back to activity in 48 hours
ScarNone — percutaneous venous puncture
RecurrencePossible — repeat embolization or another treatment remain options
CostCovered by French national health insurance at Cochin AP-HP — no out-of-pocket fees

Patient selection is decisive. Embolization only treats venous leak confirmed on imaging; patients whose erectile dysfunction has another cause (arterial, hormonal, neurological or psychogenic) will not benefit. A full diagnostic work-up by an experienced team with the complete imaging platform is therefore essential. Data validated by the team of Prof. Anthony Dohan, Department of Interventional Radiology, Cochin Hospital AP-HP, Université Paris Cité.

Frequently asked questions

What is the success rate of venous embolization for erectile dysfunction?
Results vary depending on the extent of the leak and associated factors. Clinical improvement is reported in 60–80% of carefully selected patients. The procedure can be repeated if partial occlusion is achieved initially.
Does the procedure affect sensation or orgasm?
Venous embolization does not affect penile sensitivity or ejaculation. It targets only the pathological venous drainage.
What documents should I bring to the consultation?
Please bring the result of your pharmacological Doppler ultrasound, any previous urology letters, and your current medication list (particularly PDE5 inhibitors). The IIEF questionnaire (available on our website) is also helpful.
Is embolization for venous leak effective?
In correctly selected patients with an imaging-confirmed venous leak, erection improves in 60–75% of cases in the medium term. The result depends directly on the quality of patient selection beforehand.
What is the difference between venous leak and 'ordinary' erectile dysfunction?
Venous leak is a specific organic cause: blood escapes from the corpora cavernosa through abnormal veins. It differs from arterial, hormonal, neurological and psychogenic causes. It is suspected when tablets (PDE5 inhibitors) fail, and confirmed by cavernosography/CT.
How is it diagnosed?
With a pharmaco-induced penile Doppler ultrasound and, above all, cavernosography/CT, which shows the leaking veins precisely and allows the embolization to be planned.
Why is patient selection so important?
Because embolization only helps if the cause is truly a venous leak. Offering it without a complete work-up would mean treating blind. This is why the procedure should be carried out by a team with the full diagnostic platform: hormonal tests, validated questionnaires, Doppler ultrasound and cavernosography/CT.
Is it painful?
The procedure is performed under general anaesthesia as a day case. Recovery is straightforward, with a return to normal activity in around 48 hours.

📄 Patient information: Download PDF → | IIEF Questionnaire →

✅ Covered by French health insurance (Assurance Maladie). No extra fees at Cochin Hospital AP-HP.

Why this page is trustworthy

Written by the Interventional Radiology team at Cochin Hospital AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist of the department. Last updated: August 2026.

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