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Penile Revascularization

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Abstract

With one exception, all therapeutic strategies for the management of the impotent male are treatments and not curative. The exception to this is penile revascularization. Penile microsurgical artery bypass surgery offers a distinct subpopulation of impotent patients (small in number) a potential cure for their problem. This operation was first attempted in the 1970s and has undergone many refinements since its first description by Michal et al. [1–3]. Many variations have been described by workers such as Virag et al. [4,5], Hauri [6], Crespo et al. [7], Goldstein [8], and Hatzichristou and Goldstein [9]. Currently, the most widely performed form of bypass procedure uses anastomosis of the inferior epigastric artery to one or both dorsal arteries of the penis. The overall goal of penile revascularization surgery is to bypass an obstructive arterial lesion in either the common penile or cavernosal artery. The specific objective of this surgery is to increase the blood pressure in the cavernosal artery and therefore the corpus cavernosum.

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References

  1. Michal V, Krama R, Popischal J, et al.: Direct arterial anastomosis on corporal cavernosa penis in therapy of erectile dysfunction. Rozhl Chir 1973, 52:587–590.

    PubMed  CAS  Google Scholar 

  2. Michal V, Kramer R, Popischal J: Femoropudendal bypass, internal iliac thromboendarterectomy and direct arterial anastomosis to the cavernous body in the treatment of erectile impotence. Bull Soc Int Chir 1974, 33:341–345.

    Google Scholar 

  3. Michal V, Kramer R, Popischal J, et al.: Arterial epigastricocavernous anastomosis for the treatment of sexual impotence. World J Surg 1977, 1:515–519.

    Article  PubMed  CAS  Google Scholar 

  4. Virag R, Zwang G, Dermange H, et al.: Vasculogenic impotence: a review of 92 cases with 54 surgical operations. Vase Surg 1981, 121:774–777.

    Google Scholar 

  5. Virag R, Bouilly P, Frydaman D: Is impotence an arterial disorder? A study of arterial risk factors in 400 impotent men. Lancet 1985, 1:181–184.

    Article  PubMed  CAS  Google Scholar 

  6. Hauri D: A new operative technique in vasculogenic erectile dysfunction. World J Urol 1986, 4:237–249.

    Article  Google Scholar 

  7. Crespo F, Soltanik E, Bove D: Treatment of vasculogenic sexual impotence by revascularizing cavernous and/or dorsal arteries using microvascular techniques. Urology 1982, 20:271–275.

    Article  PubMed  CAS  Google Scholar 

  8. Goldstein I: Review of types and results of vascular surgical procedures for impotence. Cardiovasc Intervent Radiol 1988, 11:240–244.

    Article  PubMed  CAS  Google Scholar 

  9. Hatzichristou DG, Goldstein I: Arterial bypass surgery for impotence. Curr Opin Urol 1991, 1:114–114-122.

    Article  Google Scholar 

  10. Goldstein I: Vascular diseases of the penis. In Clinical Urography. Edited by Pollack H. Philadelphia: WB Saunders; 1990: 2231–2252.

    Google Scholar 

  11. Krane RJ, Goldstein I, Saenz de Tejada I: Impotence. N Engl Med J 1989, 321:1648–1659.

    Article  CAS  Google Scholar 

  12. Nehra A, Udelson D, Saenz de Tejada I, Goldstein I: Pathophysiologic mechanisms in corporovenocclusive dysfunction: correlation with corporal smooth muscle content. J Urol 1996, 156:554–558.

    Article  Google Scholar 

  13. DePalma RG: The role of the vascular surgeon in diagnosis and treatment of impotence [editorial]. Eur J Vase Endovasc Surg 1995, 9:4–6.

    Article  CAS  Google Scholar 

  14. Melman A, Riccardi R Jr: The success of microsurgical penile revascularization in treating arteriogenic impotence. Int J Impot Res 1993, 5:47–52.

    PubMed  CAS  Google Scholar 

  15. Cookson MS, Phillips DL, Huff ME, Fitch WP III: Analysis of microsurgical penile revascularization results by etiology of impotence. J Urol 1993, 149:1308–1312.

    PubMed  CAS  Google Scholar 

  16. Jarow JP, DeFranzo AJ: Long-term results of arterial bypass surgery for impotence secondary to segmental vascular disease. J Urol 1996, 156:982–985.

    Article  PubMed  CAS  Google Scholar 

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© 1999 Springer Science+Business Media New York

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Mulhall, J.P., Goldstein, I. (1999). Penile Revascularization. In: Lue, T.F., Goldstein, M. (eds) Impotence and Infertility. Current Medicine Group, London. https://doi.org/10.1007/978-1-4613-1105-8_6

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  • DOI: https://doi.org/10.1007/978-1-4613-1105-8_6

  • Publisher Name: Current Medicine Group, London

  • Print ISBN: 978-1-4757-0803-5

  • Online ISBN: 978-1-4613-1105-8

  • eBook Packages: Springer Book Archive

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