Quick answer
Penile venous leak is a vascular cause of erectile dysfunction, diagnosed by cavernosography. The Cochin AP-HP Venous Leak Erectile Dysfunction Embolization Centre offers an outpatient percutaneous treatment targeting the responsible veins.
⭐ A complete pathway, in one place. We are one of the only centres in France providing the entire care pathway for venous leak: the complete diagnostic work-up (cavernosography and dynamic Doppler ultrasound) and embolization treatment — all with no extra fees.
📖 Centre — Erectile Dysfunction Embolization for Venous Leak at Cochin AP-HP
The Venous Leak Erectile Dysfunction Embolization Centre at Hôpital Cochin AP-HP offers minimally invasive percutaneous treatment for erectile dysfunction of venous origin (penile venous leak or veno-occlusive insufficiency). This innovative technique is intended for patients for whom medication (PDE5 inhibitors: sildenafil, tadalafil) has failed and who have a confirmed vascular cause.
A venous leak is diagnosed by cavernosography (dynamic CT scan after intracavernosal injection). Percutaneous embolization of the abnormal draining veins (dorsal or crural veins) is performed under general anaesthesia, on an outpatient basis, via the right femoral approach. 100% covered at Cochin AP-HP, with no extra fees.
⚡ Venous leak centre at a glance — Key facts
Our centre treats erectile dysfunction related to a confirmed penile venous leak, by percutaneous embolization, after a complete diagnostic work-up (cavernosography, Doppler ultrasound).
| Criteria | Data |
|---|---|
| Efficacy | 60 to 75% improvement in well-selected patients |
| Essential condition | Venous leak confirmed on cavernosography before any treatment |
| Anaesthesia / hospitalization | General — outpatient, back to normal in 48h |
| Coverage | Covered by French national health insurance at Cochin AP-HP — no extra fees |
Data validated by Pr Anthony Dohan's team, Department of Interventional Radiology, Hôpital Cochin AP-HP, Université Paris Cité.
🎯 Who can benefit from treatment?
- Erectile dysfunction from venous leak confirmed on cavernosography (veno-occlusive insufficiency)
- Failure of PDE5 inhibitors (Viagra®, Cialis®, Levitra®) at maximum dose
- Objectively confirmed vascular cause — not indicated for purely psychogenic erectile dysfunction
- Patients with preserved nocturnal erections (positive Evans test) with documented venous leak
- Refusal of or contraindication to penile prosthesis
- Complete prior andrological work-up (testosterone, prolactin, penile Doppler ultrasound)
🔧 Our techniques
🔬 Diagnostic cavernosography
Dynamic penile CT scan after intracavernosal injection of prostaglandin E1 and contrast agent. Localizes the site of the leak (dorsal, crural or cavernosal veins) and plans the embolization.
🩸 Percutaneous embolization of the leaking veins
Selective catheterization of the penile draining veins via the right femoral approach. Embolization using coils and/or biological glue (cyanoacrylate). Performed under general anaesthesia, on an outpatient basis. Same-day discharge.
📊 Penile Doppler ultrasound
Complete vascular assessment before and after the procedure. Evaluates arterial inflow (peak systolic velocity > 35 cm/s) and confirms the venous component (resistance index < 0.75, diastolic velocity > 5 cm/s).
🤝 Coordinated andrological work-up
Care coordinated with the urology and andrology departments at Cochin. Complete hormonal work-up, psychological assessment if needed. IIEF-5 score before and after the procedure.
📊 Results
Efficacy is objectively assessed before and after the procedure using the IIEF score (International Index of Erectile Function), a reference questionnaire. Recent studies report a technical success rate close to 98%, with clinically significant improvement in erectile function in a majority of patients within the first few weeks. Results depend on the exact mechanism of the dysfunction and any associated arterial component.
ℹ️ Who is this technique NOT suitable for?
- Purely psychogenic erectile dysfunction (no vascular cause)
- Pure arterial insufficiency (insufficient arterial inflow: peak systolic velocity < 25 cm/s)
- Erectile dysfunction under androgen therapy still being optimized
- Poorly controlled diabetes with severe, unstabilized neuropathy
A complete prior vascular work-up (penile Doppler ultrasound + cavernosography) is essential before any treatment decision. The indication is determined in consultation with the referring urologist-andrologist.
🗺️ The pathway in practice
Assessment by dynamic penile Doppler ultrasound (velocity measurements, venous reflux detection) and cavernosography, to confirm the venous leak and precisely localize the responsible veins. Baseline IIEF score established.
Under general anaesthesia, via a fine venous puncture. The incompetent veins are occluded using coils and/or liquid embolic agent, under radiological guidance. Duration: approximately 1 hour.
A few hours of monitoring, then discharge. Return to normal activities quickly, avoiding intense exertion for the first few days.
Reassessment of erectile function (IIEF score) some time after the procedure. Improvement may be progressive over the first few weeks. Follow-up coordinated with the referring urologist-andrologist.
❓ Frequently asked questions
What is a penile venous leak?
How is the diagnosis confirmed?
Is venous embolization effective?
🔗 Related pages
✓ Why this page is trustworthy
Written by the Interventional Radiology team at Hôpital Cochin AP-HP, Université Paris Cité. Medically reviewed by an interventional radiologist from the department. Last updated: July 2026.