Arterial anatomy and arteriographic diagnosis of arteriogenic impotence

Bähren, W; Gall, H.; Scherb, W; Stief, Christian G.; Thon, W. F.

doi:10.1007/bf02577004

Cited by 53 publications

(19 citation statements)

References 33 publications

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“…Virag et al 22 found a 67.8% prevalence of arteriographic abnormalities in the four main blood vessels of the penis in patients in whom organic ED had been established, of whom 86% were smokers. Bahren et al 56 found that 82% of their subjects with arteriographically proved peripheral arteriosclerotic lesions were heavy smokers. In a similar study, Rosen et al 57 found smoking to be a significant independent risk factor for atherosclerotic lesions in the internal pudendal and common penile arteries.…”

Section: Effects On Penile Blood Flowmentioning

confidence: 98%

Male Sexual Function and Smoking

Biebel

Burnett

Sadeghi‐Nejad

2016

Sexual Medicine Reviews

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Section: Effects On Penile Blood Flowmentioning

confidence: 98%

Male Sexual Function and Smoking

Biebel

Burnett

Sadeghi‐Nejad

2016

Sexual Medicine Reviews

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“…The penile arterial supply displays slight variation in its anatomy [4,5]. The penis is usually supplied by branches of the internal pudendal artery, which continue as the penile artery.…”

Section: Penile Anatomymentioning

confidence: 99%

“…The solitary ventrally located corpus spongiosum is enclosed by a thinner layer of tunica albuginea and surrounds the penile urethra. The spongiosum is anatomically independent of the cavernosa.The three corpora are enclosed by the more superficial Buck's fascia.The penile arterial supply displays slight variation in its anatomy [4,5]. The penis is usually supplied by branches of the internal pudendal artery, which continue as the penile artery.…”

mentioning

confidence: 99%

Investigation of erectile dysfunction

Patel¹,

Halls²,

Patel³

2012

The British Journal of Radiology

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ABSTRACT. Erectile dysfunction (ED) represents a common and debilitating condition with a wide range of organic and non-organic causes. Physical aetiologies can be divided into disorders affecting arterial inflow, the venous occlusion mechanism or the penile structure itself. Various imaging modalities can be utilised to investigate the physical causes of ED, but penile Doppler sonography (PDS) is the most informative technique, indicated in those patients with ED who do not respond to oral pharmacological agents (e.g. phosphodiesterase type 5 inhibitors). This review will examine the anatomical and physiological basis of penile erection, the method for performing PDS and features of specific causes of ED, and will also consider the alternative imaging modalities available. Erectile dysfunction (ED) represents a substantial burden upon public health. Studies have estimated that approximately 50% of the male population aged between 40 and 70 years will suffer from ED at some stage, with 10% of these affected severely [1]. On average, a general practitioner is estimated to see between one and five new cases of ED per month [2], and the impact upon the psychosocial health of the sufferer and his relationships may be considerable. ED is defined as the persistent inability to achieve or maintain penile erections of sufficient value to engage in satisfactory sexual activity [3]. Impotence tends not to be used as a descriptive terminology currently as it is felt to imply failure.Many physical causes of ED exist, with only 10-20% of sufferers believed to have a solely psychological cause [2]. There are many organic causes for ED, with the majority of these based upon vascular insufficiency. These organic causes are summarised in Table 1.Imaging in the investigation of ED is dominated by penile Doppler sonography and the main focus of this article will examine this technique. Alternative modalities such as MRI and angiography will also be explored, and the penile anatomy and the physiology of erection will be outlined. Penile anatomyThe central erectile structures are bilateral corpora cavernosa, seen as dorsolaterally placed low-reflectivity bodies on ultrasound, surrounded by the thick fibrous tunica albuginea (Figures 1 and 2). The corpora cavernosa are formed by multiple sinusoids composed of endothelium and smooth muscle. These sinusoids are capable of substantial volume expansion. The solitary ventrally located corpus spongiosum is enclosed by a thinner layer of tunica albuginea and surrounds the penile urethra. The spongiosum is anatomically independent of the cavernosa.The three corpora are enclosed by the more superficial Buck's fascia.The penile arterial supply displays slight variation in its anatomy [4,5]. The penis is usually supplied by branches of the internal pudendal artery, which continue as the penile artery. The bulbar artery supplies the proximal shaft and is the first branch of the penile artery, which then divides into the dorsal and cavernosal arteries (Figure 3). The cavernosal artery enters and ...

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“…For example, the common penile artery may arise from the terminus of the internal pudendal artery or from an accessory pudendal artery. Also, unilateral absence or hypoplasia of a dorsal artery has been shown in up to 30% of potent volunteers in a series by Bahren et al 13 It is this variability in penile arterial anatomy that leads to frequent misinterpretations of duplex ultrasonography, and therefore, pudendal arteriography remains the current gold standard for penile arterial evaluation.…”

Section: Duplex Ultrasonographymentioning

confidence: 99%

Radiologic evaluation of penile arterial anatomy in arteriogenic impotence

1997

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Functional and anatomic evaluation of penile arterial blood¯ow is essential in the work up of erectile dysfunction. Duplex ultrasonography is an ideal screening modality with cavernosal mean peak systolic blood¯ow velocity being the most sensitive predictor of arterial disease. Arterial variability of the penis may affect sonographic evaluation leading to frequent misinterpretation and therefore pudendal arteriography remains the current gold standard for penile arterial evaluation. Appreciation of the type and frequency of anatomic variants and potential collateral routes is important in interpreting penile arteriograms and in evaluating the hemodynamic signi®cance of suspected arterial disease.

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Arterial anatomy and arteriographic diagnosis of arteriogenic impotence

Cited by 53 publications

References 33 publications

Male Sexual Function and Smoking

Male Sexual Function and Smoking

Investigation of erectile dysfunction

Radiologic evaluation of penile arterial anatomy in arteriogenic impotence

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