Pharmacoarteriography in Chronic Erectile Dysfunction

  • W. Bähren
  • H. Gall
  • W. Scherb
  • G. Holzki
  • C. Sparwasser


Owing to the complex nature and often multifactorial genesis of chronic erectile dysfunction, diagnosis and management require a comprehensive testing program. Noninvasive morphologic and functional assessment of the penile arterial supply followed by selective bilateral pharmacoarteriography of pudendal and penile arteries is necessary to define the extent and vascular nature of pathomorphologic change, especially prior to invasive therapeutic procedures. A valid indication must exist after careful evaluation of preceeding multidisciplinary investigations.


Erectile Dysfunction Epidural Anesthesia Internal Iliac Artery Vasoactive Substance Internal Pudendal Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Adachi B (1927) Das Arteriensystem der Japaner, Bd II. Supp ad Acta scholae medicinalis unversitatis imperialis Kyoto 9: 95–125Google Scholar
  2. 2.
    Ahmed MM (1967) Age and sex differences in the structure of the tunica media of the human aorta. Acta Anat 66: 45–53PubMedCrossRefGoogle Scholar
  3. 3.
    Bähren W (1985) Erektile Dysfunktion: Selektive arteriographische Diagnostik und Therapie unter Anwendung vasoaktiver Substanzen. Habilitationsschrift Ulm, S 126–130Google Scholar
  4. 4.
    Bähren W, Stief CG, Scherb W, Gall H, Gallwitz A, Altwein JE (1986) Rationelle Diagnostik der erektilen Dysfunktion unter Anwendung eines pharmakologischen Testes. Akt Urologie 4: 177–180CrossRefGoogle Scholar
  5. 5.
    Bähren, W, Gall H, Scherb W, Stief C, Thon W (1988) Arterial anatomy and arteriographic diagnosis of arteriogenic impotence. Cardiovasc Intervent Radiol 11: 195–210PubMedCrossRefGoogle Scholar
  6. 6.
    Bookstein JJ, Valji K, Parsons L, Kessler W (1987) Pharmacoarteriography in the evaluation of impotence. J Urol 137: 333–337PubMedGoogle Scholar
  7. 7.
    Castaneda-Zuniga WR, Smith A, Kaye K, Rusnak B, Herrera M, Miller R, Amplatz K, Weens C, Ketchum D (1982) Transluminal angioplasty for treatment of vasculogenic impotence. AJR 139: 371–373PubMedGoogle Scholar
  8. 8.
    Forster A (1903) Beiträge zur Anatomie der äußeren männlichen Geschlechtsorgane des Menschen. Z Morphol Anthropol 6: 435–501Google Scholar
  9. 9.
    Ginestie JF, Romieu A (1976) L’exploration radiologique de l’impuissance. Malonie, Paris, pp 2–24Google Scholar
  10. 10.
    Goldstein I (1986) Revascularization procedures. Semin Urol IV (4): 252–258Google Scholar
  11. 11.
    Goldstein I, Siroky MB, Nath RL, McMillan TN, Menzoian JV, Krane RJ (1982) Vasculogenic impotence: Role of the pelvic steal test. J Urol 128: 300–306PubMedGoogle Scholar
  12. 12.
    Gray H (1973) Gray’s anatomy of the human body. Lea & Febinger, Philadelphia, p 648Google Scholar
  13. Gray R, Keresteci A, St. Louis E, Grosman H, Jewett M, Rankin J, Provan J (1982) Investigation of impotence by internal pudendal angiography: Experience with 73 cases. Radiology 144:773–780Google Scholar
  14. 14.
    Hartmann K (1955) Blasen-und Harnröhrenverletzungen bei Beckenbrüchen. Langenbecks Arch Klin Chir 282: 943–949Google Scholar
  15. 15.
    Hauri D (1984) Vascular reconstruction. Read at Symposium: Controversy in the Diagnosis and Treatment of Erectile Impotence, Nov 30—Dec 1, 1984, Leiden, The NetherlandsGoogle Scholar
  16. 16.
    Huguet JF, Clerissi J, Juhan C (1981) Radiologic anatomy of pudendal artery. Eur J Radiol 1: 278–284PubMedGoogle Scholar
  17. 17.
    Juhan CM, Huguet JF, Clerissi JA, Courjaret P (1980) Classification of internal pudendal artery lesions in one-hundred cases. In: Zorgniotti AW, Rossi G (eds) Vasculogenic impotence. Thomas, Springfield, pp 153–169Google Scholar
  18. 18.
    Kholoussy AM, Gain T, Matsumoto T (1981) Impotence after aorto-iliac surgery: Current concepts. Angiology 32 (9): 589–594PubMedCrossRefGoogle Scholar
  19. 19.
    Langer C (1862) Über das Gefäßsystem der männlichen Schwellorgane. Sitzungsber Akad Wiss Wien Math Naturwiss KI 46: 120–129Google Scholar
  20. 20.
    Leipner N, Porst H, Köster O, Nadstawek J (1986) DSA und konventionelle Angiographie im Vergleich bei der angiographischen Diagnostik der Impotentia coeundi. Fortschr Röntgenstr 144 (5): 515–522CrossRefGoogle Scholar
  21. 21.
    Leriche R (1923) Des oblitérations artérielles hautes comme cause d’une insuffisance circulatoire des membres inférieurs. Bull Soc Chirurgie 49: 1404–1406Google Scholar
  22. 22.
    Lue T, Tanagho EA (1985) Diagnostische Abklärung der erektilen Impotenz. Akt Urol 16: 244–249CrossRefGoogle Scholar
  23. 23.
    Lue TF, Jünemann KP, Fournier GR, Tanagho EA (1986) Mechanism of penile erection. ISIR (ed) Proc 2nd World Meeting on Impotence (Abstract 1.1) PragGoogle Scholar
  24. 24.
    Luric AL, Bookstein J, Kessler W (1988) Angiography of posttraumatic impotence. Cardiovasc Intervent Radiol 11: 232–236CrossRefGoogle Scholar
  25. 25.
    May AG, Weese JA de Rob CG (1969) Changes in sexual function following operation on the abdominal aorta. Surgery 65 (1): 41–47Google Scholar
  26. 26.
    Metz P, Herning M (1984) Impotence and aorto-iliac disease with special reference to the pelvic steal syndrome. Int Angiol 3: 259–262Google Scholar
  27. 27.
    Michal V, Pospichal J (1978) Phalloarteriography in the diagnosis of erectile impotence. World J Surg 2: 239–248PubMedCrossRefGoogle Scholar
  28. 28.
    Michal V, Kramar R, Bartak V (1974) Femoro-pudendal bypass in the treatment of sexual impotence. J Cardiovasc Surg 15: 356–359Google Scholar
  29. 29.
    Michal V, Kramar R, Pospichal J (1978) External iliac “steal syndrome”. J Cardiovasc Surg 19: 355–357Google Scholar
  30. 30.
    Michal V, Kramar R, Highal L, First P (1980) Aortoiliac occlusive disease. In: Zorgniotti AW, Rossi G (eds) Vasulogenic impotence. Thomas, Springfield, pp 185–215Google Scholar
  31. 31.
    Michal V, Kovac J, Belan A (1984) Arterial lesions in impotence: Phalloarteriography. Int Angiol 3: 247–254Google Scholar
  32. 32.
    Mitchell JP (1968) Injuries to the urethra. Br J Urol 4: 649–654Google Scholar
  33. 33.
    Müller J (1935) Entdeckung der bei der Erektion wirksamen Arterien. Arch Anat 202–213Google Scholar
  34. 34.
    Nath RL, Menzoian JO, Kaplan KH, McMillian TN, Siroky MB, Krane RJ (1981) The mutlidisciplinary approach to vasculogenic impotence. Surgery 89 (1): 124–133PubMedGoogle Scholar
  35. 35.
    Palma RG de Levine SB, Feldman S (1978) Preservation of erectile function after aorto-iliac reconstruction. Arch Surg 113: 958–962CrossRefGoogle Scholar
  36. 36.
    Queral LA, Whithehouse WM, Flinn WR, Zarins CK, Bergan JJ, Yao JS (1979) Pelvic hemodynamics after aortoiliac reconstruction. Surgery 86 (6): 799–808PubMedGoogle Scholar
  37. 37.
    Rotter W, Schürmann R (1950) Die Blutgefäße des menschlichen Penis. Virchows Arch 318: 352–393PubMedCrossRefGoogle Scholar
  38. 38.
    Sabri S, Cotton C (1971) Sexual function following aorto-iliac reconstruction. Lancet 2: 1218–1219PubMedCrossRefGoogle Scholar
  39. 39.
    Schweiger H, Zirngibl H, Raithel D (1984) Potenzstörungen vor und nach Beckenarterienrekonstruktion: Objektivierung durch Messung des Penisarteriendrucks. Chirurg 55: 95–99PubMedGoogle Scholar
  40. 40.
    Sigel A, Chlepas S (1981) Verletzungen der Harnröhre. In: Lutzeyer W (Hrsg) Traumatologie des Urogenitaltraktes. Springer, Berlin Heidelberg New York, S 131–199CrossRefGoogle Scholar
  41. 41.
    Spiro M, Cotton CT (1970) Aorto-iliac thrombendarterectomy. Br J Surg 57: 161–168PubMedCrossRefGoogle Scholar
  42. 42.
    Stieve H (1930) Männliche Genitalorgane. In: Möllendorf W (Hrsg) Handbuch der mikroskopischen Anatomie des Menschen, Bd VII/2. Springer, BerlinGoogle Scholar
  43. 43.
    Struyven J, Gregoir W, Giannakopoulos X, Wauters E (1979) Selective pudendal arteriography. Eur Urol 5: 233–242PubMedGoogle Scholar
  44. 44.
    Unnik JG van, Marsman IW (1984) Impotence due to the external iliac steal syndrome treated by percutaneous transluminal angioplasty. J Urol 131: 544–545PubMedGoogle Scholar
  45. 45.
    Valji K, Bookstein J (1988) Transluminal angioplasty in the treatment of arteriogenic impotence. Cardiovasc Intervent Radiol 11: 245–252PubMedCrossRefGoogle Scholar
  46. 46.
    Virag R (1981) Pelvic steal syndrome. Vasa 9: 304–307Google Scholar
  47. 47.
    Virag R (1984) Impotence: A new field in angiology. Int Angiol 3: 217–220Google Scholar
  48. 48.
    Virag R (1984) The treatment of angiogenic impotence. Int Angiol 3: 275–280Google Scholar
  49. 49.
    Wagner G, Green R (1981) Impotence. Plenum Press, New York London, pp 62–72Google Scholar
  50. 50.
    Watt JK, Gillespie G, Pollack JG (1974) Arterial surgery in intermittent claudication. Br Med J 1: 23–27PubMedCrossRefGoogle Scholar
  51. 51.
    Zorgniotti AW, Padula G, Shaw WW (1983) Selective arteriography for vascular impotence. World J Urol 1: 213–217CrossRefGoogle Scholar
  52. 52.
    Zorgniotti AW, Shaw WW, Padula G, Rossi G (1984) Impotence associated with pudendal arteriovenous malformation. J Urol 132: 128–131PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • W. Bähren
  • H. Gall
  • W. Scherb
  • G. Holzki
  • C. Sparwasser

There are no affiliations available

Personalised recommendations