Introduction: We investigated the hypothesis that histopathological changes occur in corpora cavernosa (CC) of patients with combined venous leakage and testosterone deficiency, and that these changes could be corrected by testosterone administration. Material and Methods: Study included 21 patients with low plasma testosterone and erectile dysfunction. Investigations revealed corporal veno-occlusive dysfunction. Patients were administered 200 mg testosterone undecanoate injection every 2 weeks for 6 months. CC biopsy was examined and serum testosterone was recorded. Results: Fourteen of the 21 patients showed increased serum testosterone and improved erectile function after 15.6 ± 2.2 weeks of androgen treatment. Pretreatment CC biopsy showed degenerated muscle fibers and collagen; post-treatment picture was normalized in 6 of 8 patients. Seven patients showed no improvement. Conclusion: Histopathological changes are detected in patients with venous leakage and low serum testosterone. Correction of testosterone deficiency can improve histopathologic changes and erectile dysfunction in most of the patients.

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