Vascular surgery for impotence: a review

Abstract

Progress in treatment of impotence in the past two decades has resulted in impressive advances. While most men respond to medical therapy including prostaglandin E1 injection or the more recent use of urethral alprostadil, 6±7% of men fail to respond to these treatments or vacuum devices. This review considers current and past results of vascular surgery in this group of men. Guidelines for case selection for vascular interventions as well as reporting criteria are suggested. Vascular surgery as a logical ®rst step in selected patients may offer an advantage in men failing conservative therapy and for those not desiring prosthetic implantation.

Penile revascularization surgery for arteriogenic erectile dysfunction: the long‐term efficacy rate calculated by survival analysis

“…According to relevant reports, the longer the follow-up the worse the effective outcome [4]. However, previous studies have been retrospective and did not consider the censored cases [5].…”

Evaluation of penile revascularization for erectile dysfunction: a 10-year follow-up

“…To our knowledge, the longest follow-up reported to date is of 54 months. 5 The existing data from these studies are limited and conflicting, necessitating a further breakdown and stratification into risk factor categories in order to determine the group of patients that will most benefit from such a procedure.…”

Epidemiology of Male Sexual Dysfunction

“…Trauma to the brain, spinal cord, or perineum is well associated with ED and/or ejaculation disorders (Linsenmeyer, 2000). The common pathophysiology among these risk factors includes disruption of the neural and arterial supply to the penis and the genital tract as well as dysfunction of the venoocclusive mechanism in certain cases (DePalma, 1997). Although perineal pressure associated with bicycling is associated with ED, evidence-based support is still lacking (Marceau, Kleinman, Goldstein, & McKinlay, 2001;Taylor, Kao, Albertsen, & Shabsigh, 2004).…”