Lesion Pattern in Patients With Erectile Dysfunction of Suspected Arterial Origin

Allmen, Regula S. von; Nguyen, Daniel P.; Birkhäuser, Frédéric D.; Bednar, Rudolf; Kammer, Rafael Franz; Do, Dai-Do; Diehm, Nicolas

doi:10.1177/1526602815613789

Cited by 8 publications

(17 citation statements)

References 26 publications

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“…Based on these fi ndings, drug-eluting stenting of the pudendal arteries is considered safe and benefi cial to the majority of patients. Nevertheless, the rate of non-responders was rather high (40.1 %), which may be attributed to microangiopathy frequently observed in ED patients [43] and to other co-morbidities.…”

Section: Arterial Imaging and Endovascular Therapy Of Arteriogenic Edmentioning

confidence: 88%

“…Balloon angioplasty of the pudendal artery was shown to restore blood fl ow and substantially improve the symptoms of ED during short-term follow-up [44]. However, it is noteworthy that arteriogenic ED is accompanied by a veno-occlusive disorder in up to 80 % of patients [43]. The value of intra-arterial pressure gradient measurements is unclear.…”

Section: Arterial Imaging and Endovascular Therapy Of Arteriogenic Edmentioning

confidence: 98%

“…Von Allmen et al published data on lesion morphology of 26 patients not responsive to PDE-5 inhibitors and thus, suspected to suff er from arteriogenic ED [43]. Arterial lesions were assessed by angiography and classifi ed as macro and microangiopatic.…”

Section: Arterial Imaging and Endovascular Therapy Of Arteriogenic Edmentioning

confidence: 99%

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Erectile dysfunction – overview from a cardiovascular perspective

Baumann¹,

Hehli

Makaloski

et al. 2017

Vasa

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Summary:Erectile dysfunction (ED) is an evolving health problem with growing incidence in the ageing male population with potentially predictive value for cardiovascular and other chronic diseases. ED shares the common cardiovascular risk factors. The aetiology of ED is numerous including neurogenic, psychogenic, arteriogenic, and venogenic reasons. The origin of arteriogenic ED is frequently atherosclerosis. Patients not adequately responding to conservative measures including oral medication are often referred to further vascular diagnostics and therapy. At present, the refi nements in endovascular therapy allow for minimal-invasive revascularization of erection-related arteries. The role of endovascular therapy in the complex framework of the multifactorial causes of ED requires further scientifi c scrutiny.

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Section: Arterial Imaging and Endovascular Therapy Of Arteriogenic Edmentioning

confidence: 88%

Section: Arterial Imaging and Endovascular Therapy Of Arteriogenic Edmentioning

confidence: 98%

See 1 more Smart Citation

Erectile dysfunction – overview from a cardiovascular perspective

Baumann¹,

Hehli

Makaloski

et al. 2017

Vasa

Self Cite

View full text Add to dashboard Cite

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“…In the next study, von Allmen et al [12] attempted to identify a specific pattern of damage to the arteries supplying the penis in ED patients with an incomplete response to PDE5I and CAD and/or coexisting cardiovascular risk factors in history. They examined 26 men (average age: 55) who had been sexually active with the same partner for over six months and had made four unsuccessful intercourse attempts in a month after taking PDE5I.…”

Section: Reviewmentioning

confidence: 99%

“…It has been proved that as many as 90% of patients with a weak response to PDE5I show significant atherosclerotic lesions which cause arterial insufficiency in angiography [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Modern Endovascular Treatment Methods for Erectile Dysfunction: A Critical Analysis

Piegza¹,

Paterak²,

Błachut³

et al. 2020

Wiad Lek

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75% of men with coronary artery disease confirmed by coronarography have erectile dysfunction in history, while 75% of patients with a vascular etiology of ED have significant stenoses in penile arterial vascularization. Patients with coronary artery disease have shown a relationship between the range of the lesions in the coronary vessels and erectile dysfunction intensity. This paper aims at attempting to systematize the knowledge of the benefits and drawbacks of nonsurgical endovascular treatment methods for erectile dysfunction with confirmed vascular causes. It analyzes seven studies which assess the results of erectile dysfunction treatment with percutaneous angioplasty. It also mentions the limitations of the cited works and formulates relevant conclusions. Conclusions: The analysis shows that endovascular procedures in erection-related arteries are safe in a specially selected group of men. It is necessary to conduct further studies to define an appropriate group of patients who have a chance of benefiting optimally from the endovascular treatment of erectile dysfunction in a long-term follow-up.

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Effect of pelvic arterial stenosis on erectile function: determining the severity threshold for erectile dysfunction

Huang,

Tung,

Tseng

et al. 2024

The Journal of Sexual Medicine

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Background Pelvic arterial (PLA) stenosis is associated with arterial insufficiency of the penis and erectile dysfunction (ED), but the effect of different severities of PLA stenosis on ED remains unclear. Aim To investigate how different severities of PLA stenosis affect erectile function. Methods We included patients who visited our clinic for ED and underwent computed tomography angiography (CTA) and dynamic duplex sonography (DUS). The erectile hardness score (EHS), simplified International Index of Erectile Function (IIEF-5), DUS and CTA results, and flow index (FI) calculated from the peak systolic velocity (PSV) and PLA stenosis percentages were analyzed. EHS < 3 was defined as significant ED. PLA stenosis was analyzed by the mean PLA (average of the right and left PLA) and unilateral or bilateral stenoses. According to severity, stenosis was classified as mild, moderate, or severe. Outcomes Subjective and objective parameters, including the IIEF-5 score, EHS, PSV, and FI, in relation to different severities of PLA stenosis. Results The study included 182 patients. Vascular parameters such as the mean PSV, PLA stenosis, and FI correlated with EHS and IIEF-5 scores. Receiver operating characteristic analyses for predicting EHS ≥ 3 showed that all vascular parameters had acceptable discriminatory ability. During the analysis performed using the mean PSA stenosis, EHS decreased in patients with mild and severe mean PLA stenosis, although a PSV drop was noted only in severe cases. The proportion achieving EHS 3 significantly dropped in patients with at least mild mean PLA stenosis. Using unilateral or bilateral PLA stenosis, the EHS significantly dropped in patients with severe unilateral and bilateral PLA stenosis, with PSV decreasing on the affected side in severe unilateral stenosis. However, the mean PSV did not drop despite different unilateral stenosis severities. The proportion achieving EHS 3 significantly dropped among patients with at least moderate unilateral PLA stenosis and bilateral PLA stenosis but not in mild unilateral cases. Clinical Implications The severity of PLA stenosis is correlated with the risk of ED. Strengths & Limitations The strength of this study lies in its analysis of the effect of PLA stenosis on erectile function from various perspectives, including unilateral, bilateral, and mean stenosis. However, the absence of validation regarding the outcomes of endovascular therapy is a limitation. Conclusion Mild mean PLA stenosis and moderate unilateral PLA stenosis are associated with increased risks of ED; however, mild unilateral PLA stenosis does not affect erectile function.

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Lesion Pattern in Patients With Erectile Dysfunction of Suspected Arterial Origin

Cited by 8 publications

References 26 publications

Erectile dysfunction – overview from a cardiovascular perspective

Erectile dysfunction – overview from a cardiovascular perspective

Modern Endovascular Treatment Methods for Erectile Dysfunction: A Critical Analysis

Effect of pelvic arterial stenosis on erectile function: determining the severity threshold for erectile dysfunction

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