Pharmacoarteriography in the Evaluation of Impotence

Abstract

Progress in diagnosis and therapy of impotence is handicapped by the absence of a validated and objective method for evaluating the vascular system; a gold-standard for vasculogenic impotence is needed. Prior experience has indicated that conventional arteriography in unanesthetized patients is unreliable in evaluation of the penile arterial supply. We have improved our arteriographic methods by the routine application of selective pudendal injections, vasodilation pharmacoangiography with nitroglycerin and papaverine, and direct magnification. Experience in 37 impotent patients demonstrates marked improvement in the quality of visualization of distal vessels, and the frequent presence of functional vasoconstriction of medium and small arteries that can be distinguished from organic disease only with vasodilators. We believe these angiographic methods will improve the criteria against which other diagnostic and therapeutic methods can be objectively assessed.

Arterial anatomy and arteriographic diagnosis of arteriogenic impotence

“…Further refinement of the technique by the use of artificial erection and intracavernous application of vasoactire substances has led to marked improvement in the quality of visualization of distal vessels (Fig. I) [2][3][4][5].…”

Subclinical Trauma to Perineum: A Possible Etiology of Erectile Dysfunction in Young Men

“…Empirical judgment is the main criterion for the analy sis of penile angiography [15] and these criteria are basi cally dependent on personal experience. As far as we see, duplex sonography of the penile arteries does not show any superiority to angiography because this test is also very much dependent on the examiner's experience [18-arterial lesions at the same site as subclinical trauma.…”

“…Some of them may have malfor mations of the arteries [7], a dysfunction of the erectile tissues [8] or secondary occlusive arterial disease without obvious reasons. An occlusive arterial disease as a sequel common penile, dorsal and cavernous arteries were assessed on the basis of the selective injection films which were done with digital subtraction angiography [1,[14][15][16]. Vasospasms observed during the radiological intervention were relieved by local infusion of nitroglyc erin.…”

Functional Evaluation of Penile Hemodynamics

“…Selective pharmacoangiography of the pelvis and penis was performed in 59 patients 4 and dynamic cavernosography 13,14 was done in 69. The correlation between the result of Doppler ultrasonography and angiography was 94.5 per cent.…”