Arterial epigastricocavernous anastomosis for the treatment of sexual impotence

Michał,; Kramar, Reinhard; Pospíchal, J; Hejhal, L

doi:10.1007/bf01565928

Cited by 122 publications

(42 citation statements)

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“…[1] on successful penile revascularization in 1974, more than 15 different operative techniques have been developed with extremely varying success rates [1][2][3].In a previous study,we reported our surgical results using the modified Furlow-Fisher technique in 25 patients with 4-year follow-up. In that study, which was the first report on this issue, the importance of CC-EMG findings in the preoperative evaluation was discussed and the IIEF score was used for the postoperative evaluation of the patients who had undergone revascularization surgery [15].…”

Section: Discussionmentioning

confidence: 99%

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Penile revascularization in vasculogenic erectile dysfunction (ED): long‐term follow‐up

Kayıgίl¹,

Okulu²,

Aldemir³

et al. 2011

BJU International

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Study Type – Therapy (case series)Level of Evidence 4What’s known on the subject? and What does the study add?This study reflects the second largest series of revascularization operations performed in different etiologic and risk groups with the longest follow up. Beyond that this is the only study in which CC‐EMG techniques were used preoperatively to exclude some patients and to predict postoperative success in penile revascularization.OBJECTIVE• To determine the overall long‐term success of penile revascularization surgery in the treatment of vasculogenic erectile dysfunction (ED) and also to investigate the effect of risk factors on the results of a modified Furlow–Fisher technique.PATIENTS AND METHODS• Between 1999 and 2010, 125 men with a mean (sd, range) age of 43.2 (11.3, 23–69) years underwent penile revascularization surgery. In all, 110 men completed the long‐term follow‐up with a mean follow‐up of 73.2 months.• Diagnostic evaluations, penile colour Doppler ultrasonography, corpus cavernosum electromyography, and cavernosometry, were performed in all the men before surgery.• The efficacy of the surgery was assessed as improvement or failure according to the change in the five‐item version of the International Index of Erectile Function (IIEF‐5). A ≥5 point increase in the IIEF‐5 score during the latest patient visit after surgery compared with that before surgery was regarded as improvement (surgical success).RESULTS• The mean (sd) IIEF‐5 score was 7.3 (3.2) before surgery and at the end of the follow‐up periodit was 16.8 (3.1).• The success rates were 81.8% at 3 months, 77.2% at 1 year, 70% at 2 years, 66.3% at 3 years and 63.6% at 5 years after surgery in the men who achieved a no‐ED threshold score of >26 in the IIEF‐15.• The success rate was the highest in the men with no risk factors (92.8%).• Seven patients (6.36%) showed signs of glans hypervascularization as a major complication.CONCLUSIONS• Penile revascularization surgery has not been widely used by urologists probably due to the technical difficulties and the use of phosphodiesterase type 5 inhibitors.• However, with reported high rates of noncompliance or failure of oral pharmacotherapy it seems likely that this surgery will become more popular in the near future.

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Section: Discussionmentioning

confidence: 99%

“…Since the first report of Michal et al . [1] on successful penile revascularization in 1974, more than 15 different operative techniques have been developed, with extremely varying success rates [2][3][4]. Deep dorsal vein arterializations have been described by Virag et al .…”

Section: Introductionmentioning

confidence: 99%

Penile revascularization in vasculogenic erectile dysfunction (ED): long‐term follow‐up

Kayıgίl¹,

Okulu²,

Aldemir³

et al. 2011

BJU International

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“…Newman, Northup and Devlin reported a maintenance rate of 12 ml min À1 and an induction rate of 20-50 ml min À1 . 45 Michel et al 49 revealed a maintenance rate of 50-70 % and an induction rate of 45-170 ml min…”

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confidence: 97%

The engineering analysis of bioheat equation and penile hemodynamic relationships in the diagnosis of erectile dysfunction: part I—theoretical study and mathematical modeling

Chia

2007

Int J Impot Res

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The extent to which skin surface bioheat perfusion predicts penile physiological response such as an erection has not been extensively investigated. A biomechanical engineering study was performed to compare bioheat distribution on penile skin surface resulting from an induced erection at steady state to examine the efficacy of such method as an adjunct tool for the diagnosis and classification of erectile dysfunction (ED) due to different etiology. We based our arguments on the principle that blood vessel activity and perfusion to corpus cavernosa at the erect state are almost always higher than that in the flaccid state. Our results showed that a difference of 0.1-0.3 1C can be observed and hence used to develop database of 'smart diagnosis' for ED using the machine artificial intelligence. It is anticipated that such basic research into blood flow is critical, as blood perfusion into corpus cavernosa is the most influential factor determining functional erectile quality contributing to successful coitus. Increased understanding of the hemodynamic response profile contributes toward optimal treatment and thus enables clinicians to adopt an appropriate management scheme for ED. IntroductionErectile dysfunction (ED) is the failure to develop and maintain erections of sufficient rigidity for penetrative sexual intercourse.1 In all cultures, the issue of ED has always been linked with masculinity; having the false believe that the capacity of a strong erection is a symbolic of strong men. The frequency of ED and its related research have not been well investigated, partially due to its sensitivity of information and respondents giving unreliable replies. The diagnosis of ED has also been held back by the lack of objective definition of the problems, and sometimes due to the reluctance of physicians and patients in carrying out certain conversations. However, the cause of ED are frequently multiple, with psychological, neurological, endocrinological, vascular, traumatic and chemical components being described. The precise role of environmental and lifestyle factors such as smoking, stress, hypertension and diabetes mellitus in the development of ED has been proposed as potential risk factors. The complexity of research in the area of sexual arousal of men is probably due to erectile function, which being a function of great evolutionary antiquity is very much subjected to erotic stimuli and can diminish over habituation. Experiments with animals have shown that rams introduced to fresh partners quickly restored the rates of intercourse compared with the male exposed to the same partner all the time. Rams introduced to the same partner have a much longer time to ejaculation compared with rams introduced to different partners at the same rate.2 Thus, ED, or many other sexual related diseases, are not always the failure of some biomechanical or biochemical process. The human sexual response is a complex, multifaceted phenomenon that is not completely, or nearly, understood by scientist or sexologist. To date, probabl...

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“…This procedure also proved to be unphysiological and, at best, leads to incurable priapism. Michal et al [18] modified their approach by performing anastomosis between the inferior epigastric artery and one of the dorsal arteries ( fig. 20).…”

Section: Survey Of the Different Surgical Concepts For The Treatment mentioning

confidence: 99%

A critical Review of Penile Revascularization Procedures

Hauri

1998

Urol Int

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Arterial epigastricocavernous anastomosis for the treatment of sexual impotence

Cited by 122 publications

References 0 publications

Penile revascularization in vasculogenic erectile dysfunction (ED): long‐term follow‐up

Penile revascularization in vasculogenic erectile dysfunction (ED): long‐term follow‐up

The engineering analysis of bioheat equation and penile hemodynamic relationships in the diagnosis of erectile dysfunction: part I—theoretical study and mathematical modeling

A critical Review of Penile Revascularization Procedures

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