Vasculogenic Impotence

Abstract

In 1923, Leriche first associated atherosclerotic occlusion of the infrarenal abdominal aorta with erectile dysfunction and buttock atrophy.¹ Although great advances have been made in the treatment of lower-extremity ischemia by direct reconstruction, only recently have vascular surgeons specifically addressed the identification and correction of arterial lesions causing impotence. As the public becomes increasingly aware that sexual function can be extended to the extremes of age, appropriate diagnosis and treatment of this syndrome will assume even more importance. This chapter begins with a review of the vascular anatomy of the penis and the commonly available noninvasive methods of assessing penile perfusion. Options in operative and nonoperative treatment will also be discussed.