The study objective is to define the state of the problem of surgical methods for the treatment arteriogenic forms of erectile dysfunction (ED) in the Republic of Belarus, to systematize surgical methods for the correction of arteriogenic ED, to evaluate the results of interventional, surgical and combined methods of the treatment of arteriogenic forms of ED in the Republic of Belarus.Materials and methods. A comprehensive examination was carried out 65 men with arteriogenic ED (average age 52.2 ± 2.2 year, International Index of Erectile Function – 9.6 ± 1.3 points; the hardness of erection – 2.2 ± 0.3 according to the Yunem scale) included ultrasound, multispiral computed angiography, as results of stenosing and occlusive lesions of the aorto-iliac segments, internal pudendal artery (IPA) and distal branches were revealed. Of these, as a result of atherosclerotic damage to arteries – 59 (91 %) patients, hypoplasia of the IPA – 4 (6 %) patients and in 2 (3 %) – cases due to post-traumatic damage to the IPA during fracture of the pelvic bones. Pro- and retrospectively performed analysis of the results of endovascular, surgical and combined correction of chronic arterial insufficiency of penis. Based on the results of the study, blood flow deficiency was simulated in order to determine the possible level and method of its elimination. Subsequently, 34 reconstructive operations were performed, including endovascular: superselective stenting of IPA – in 1 case, angioplasty of IPA – one-bilateral – in 4 cases, stenting of the iliac arteries – in 14 cases, in 4 cases – aorto-femoral bypass or prosthetics. Microsurgical operations with epigastric-penile anastomosis were performed in 9 cases (Virag II type in 8 cases, Michal II – Scharlip in 1 case), including in 3 cases as a second stage to increase arterial perfusion of penis after endovascular interventions. In 3 cases, for severe arteriogenic ED and endothelial insufficiency, endophalloprosthesis was implanted (AMS-Spectra).Results. According to the results of testing of patients after endovascular intervention or microsurgical reconstruction, as well as after a two-stage correction that included both methods, patients showed a statistically significant improvement in erectile function on the scale of the International Index of Erectile Function – from 9–12 points (10.0 ± 0.31 points) before surgery to 16–19 points (17.5 ± 0.25 points) 12 months after surgery (p = 0.0009).Conclusions. Interventional methods of correction after micro surgical and combined operations in patients with arteriogenic ED allow achieving a satisfactory result during the first year after surgery, provided that patients are carefully selected using a comprehensive examination, including various ultrasound techniques, multispiral computed angiography, as well as the selection of an appropriate type of revascularization.
