Summary
Erectile impotence may be due to psychological problems, neurogenic dysfunction, hormonal alterations or compromised penile blood flow. With a better understanding of the erectile mechanism and with the development of new investigative techniques, recognition of the origin of impotence has dramatically improved in recent years, indicating that the majority of these patients are impotent due to vascular abnormalities. Rather than discussing the physiology of erection and its problems, we wish to propose a rational approach to the diagnosis and treatment of vasculogenic impotence.
Similar content being viewed by others
References
Abber JC, Lue TF, Orvis BR, McClure RD, Williams RD (1986) Diagnostic tests for impotence: a comparison of papaverine injection with the penile-brachial index and nocturnal penile tumescence monitoring. J Urol:923
Barry JM, Blank B, Boileau M (1980) Nocturnal penile tumescence monitoring with stamp. Urology 15:171
Blum MD, Bahnson RR, Porter TN, Carter MF (1985) Effect of a local alpha-adrenergic blockade on human penile erection. J Urol 134:479
Brindley GS (1986) Pilot experiments on the actions of drugs injected into the human corpus cavernosum penis. Br J Pharmac 87:495
Buvat J, Buvat-Herbaut M, Dehaene JL, Lemaire A (1986) Is in-tracavernous injection of papaverine a reliable screening test for vascular impotence? J Urol 135:476
Casey WC (1979) Revascularization of corpus cavernosum for erectile failure. Urology 2:135
Courtheoux P, Maiza D, Henriet JP, Alachkar F, Solassol A, Maiza C, Théron J (1985) Correction des insuffisances érectiles d'origine veineuse par ballonnets largables et coils. J Radiol 66:535
Crespo E, Soltanik E, Bove D, Farrell G (1982) Treatment of vasculogenic sexual impotence by revascularizing cavernous and/or dorsal arteries using microvascular techniques. Urology 3:271
Delcour C, Wespes E, Vandenbosch G, Schulman CC, Struyven J (1986) Impotence: evaluation with cavernosography. Radiology 161:803
Ek A, Bradley WE, Krane RJ (1983) Nocturnal penile rigidity measured by the snap-gauge band. J Urol 129:964
Fisher C, Schiavi RC, Edwards A, Davis DM, Reitman M, Fine J (1979) Evaluation of nocturnal penile tumescence in the differential diagnosis of sexual impotence. Arch Gen Psychiatry 36:431
Furlow W (1981) Use of the inflatable penile prosthesis in erectile dysfunction. Urol Clin North Am 8:181
Goldlust RW, Daniel RK, Trachtenberg J (1982) Microsurgical treatment of vascular impotence. J Urol 128:821
Goldstein I, Siroky MB, North RL, McMillian TN, Menzoian JO, Krane RJ (1982) Vasculogenic impotence: role of the pelvic steal test. J Urol 128:300
Goldstein I, Mortara RW, Krane RJ (1985) Penile revascularization: three years experience. J Urol 133:189
Hawatmeh IS, Houttuin E, Gregory JG, Blair OM, Purcell MH (1982) The diagnosis and surgical management of vasculogenic impotence. J Urol 127:910
Jonas U (1983) Five years' experience with the silicone-silver penile prosthesis: improvements and new developments. World J Urol 1:251
Kaya N, Moore C, Karacan I (1979) Nocturnal penile tumescence and its role in impotence. Psychiat Ann 9:426/63
Kedia KR (1983) Penile plethysmography useful in diagnosis of vasculogenic impotence. Urol 3:235
Lue TF, Hellstrom WJG, McAnninch JW, Tanagho EA (1986) Priapism: a refined approach to diagnosis and treatment. J Urol 136:104
McDougal WS, Jeffery RF (1983) Microscopic penile revascularization. J Urol 129:517
MacGregor RJ, Konnak JW (1982) Treatment of vasculogenic erectile dysfunction by direct anastomosis of the inferior epigastric artery to the central artery of the corpus cavernosum. J Urol 127:136
Mazo R, Sonda P (1984) A prospective double-blind trial of yohimbine for erectile impotence. J Urol 131:234
Michal V, Kramar R, Bartak V (1974) Femoral pudendal bypass in the treatment of sexual impotence. J Cardiovasc Surg 15:356
Michal V, Kramar R, Pospichal J, Hejhal L (1977) Arterial epigastricocavernous anastomosis for the treatment of sexual impotence. World J Surg 1:515
Nagler HM, Katz PG, deVere White R (1982) Role of frenular penile-brachial index in the assessment of penile vasculature. Neurourol Urodynamics 1:71
Nath R, Menzoian JO, Kaplan KH, McMillian TN, Siroky MB, Krane RJ (1981) The multidisciplinary approach to vasculogenic impotence. Surgery 89:124
Reiss HF (1985) Difficulties in Doppler auscultation of cavernous arteries of penis. Urol 3:222
Robiner WN, Godec CJ, Cass AS, Meyer JJ (1982) The role of Minnesota Multiphasic Personality Inventory in evaluation of erectile dysfunction. J Urol 128:487
Schmidt HS, Wise HA (1981) Significance of impaired penile tumescence and associated polysomnographic abnormalities in the impotent patient. J Urol 126:348
Struyven J, Jeanty PH, Jeanmart J, Ghosen V, Schulman CC (1979) Angiographic evaluation of male impotence. J belge Radiol 62:597
Van Andel GJ (1980) Transluminal iliac angioplasty: long-term results. Radiology 135:607
Virag R (1981) Syndrome d'érection instable par insuffisance veineuse. J Mal Vasc 6:121
Virag R (1982) Intracavernous injection of papaverine for erectile failure. Lancet II:938
Virag R, Virag H, Lajujie L (1983) A new device for measuring penile rigidity. Urology 1:80
Virag R, Frydman D, Legman M, Virag H (1984) Intracavernous injection of papaverine as a diagnostic and therapeutic method in erectile failure. Angiology 35:79
Virag R, Bouilly P, Frydman D (1985) Is impotence an arterial disorder? Lancet 1:181
Wein AJ, Fishkin R, Carpiniello VL, Malloy TR (1981) Expansion without significant rigidity during nocturnal penile tumescence testing: a potential source of misinterpretation. J Urol 126:343
Wespes E, Schulman CC (1984) Parameters of erection. Brit J Urol 56:416
Wespes E, Delcour C, Struyven J, Schulman CC (1984) Cavernometry-cavernography: its role in organic impotence. Eur Urol 10:229
Wespes E, Schulman CC (1985) Venous leakage; surgical treatment of a curable cause of impotence. J Urol 133:796
Wespes E, Delcour C, Struyven J, Schulman CC (1986) Pharmacocavernometry-cavernography in impotence. Br J Urol 58:429
Wespes E, Delcour C, Rondeux C, Struyvent J, Schulman CC (1987) Erectile angle: objective criterion to evaluate the Papaverine test in impotence. J Urol (in press)
Zorgniotti AW, Padula G, Shaw WW (1983) Selective arteriography for vascular impotence. World J Urol 1:213
Zorgniotti AW, Lefleur RS (1985) Auto-injection of the corpus cavernosum with a vasoactive drug combination for vasculogenic impotence. J Urol 133:39
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wespes, E., Schulman, C.C. Vascular impotence. World J Urol 5, 144–149 (1987). https://doi.org/10.1007/BF00326821
Issue Date:
DOI: https://doi.org/10.1007/BF00326821