Pelvic magnetic resonance imaging angioanatomy of the arterial blood supply to the penis in suspected prostate cancer patients

Thai, Cao Tan; Karam, Ibrahim; Nguyen-Thi, Phi-Linh; Lefèvre, Frédéric; Hubert, Jacques; Felblinger, Jacques; Eschwège, P.

doi:10.1016/j.ejrad.2015.01.017

Cited by 12 publications

(6 citation statements)

References 22 publications

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“…In around 6-10%, APA can arise from inferior epigastric artery (IEA), a branch of external iliac artery (EIA). 6 Our case was unique in the aspect that left cavernosal artery was seen arising from APA which in turn arose from IEA. There was no cavernosal supply from left IPA/IIA.…”

Section: Discussionmentioning

confidence: 74%

“…The main clinical significance of such an uncommon variation lies in the fact that inadvertent injury to IEA during inguinal surgeries or dialysis catheter placements, can lead to erectile dysfunction. 5,6 Arterial priapism being non-ischemic, conservative management in the form of ice and compressive perineal dressing can be tried as an alternative option. The rationale behind medical management is to cause vasospasm of the inured vessel with subsequent thrombosis and spontaneous detumescence.…”

Section: Discussionmentioning

confidence: 99%

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Post-Traumatic High-Flow Priapism: Accessory Pudendal Origin of Cavernosal Artery From External Iliac Artery - A Case Report

Dedhia

Vignesh

Mukuntharajan

et al. 2023

Vasc Endovascular Surg

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High-flow priapism is an uncommon condition typically resulting from penile or perineal trauma, due to laceration of cavernosal artery. We present a case of 24-year-old male who presented with post-traumatic painless priapism. Ultrasound showed hematoma with arterio-cavernosal fistula. On CT Angiogram, the cavernosal artery was seen arising from accessory pudendal artery, which arose from inferior epigastric artery (IEA), branch of external iliac artery (EIA). Catheter angiogram of EIA showed fistulous communication at the base of the penis from a branch of IEA. Selective embolisation of the artery was done using 33% glue (n-butyl cyanoacrylate). Post embolisation, no residual filling of the fistula and partial detumescence of penis was noted. Transarterial embolisation is usually preferred as first line of management in high-flow fistulous priapisms.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Post-Traumatic High-Flow Priapism: Accessory Pudendal Origin of Cavernosal Artery From External Iliac Artery - A Case Report

Dedhia

Vignesh

Mukuntharajan

et al. 2023

Vasc Endovascular Surg

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“…In many previous studies, it was asserted that APAs played an important role in erectile function and should be preserved during RP, but this is still controversial [19][20][21]. Rogers et al [4] reported that the increase was more than two-fold in the possibility of recurrence in the potency condition of APA preserved mens during open retropubic RP, and potency condition recovery took less time.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Radical Prostatectomy: Accessory Pudendal Arteries Preservation and Effects on Sexual Functions

Arikan

Şeker

Yenice

et al. 2022

Preprint

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Background: Aim of this study was to show the importance of accessory pudendal arteries (APAs) on erectile function in patients who underwent robot-assisted radical prostatectomy (RALP).Methods: We retrospectively reviewed data of 988 RALP procedures performed in our institution between 2010 and 2018. 55 patients who were APA (+) and 76 patients who were APA (-) and underwent RALP procedures were included in the study. Demographic characteristics, preoperative clinical information, peroperative data and pathologic data were collected. IIEF-5 scores preoperatively and postoperative 3rd, 6th, 12th and 18th months, registered.Results: The mean age, in the study group was 61 ± 6.2 yeas. Mean BMI was 27.2 ± 1.8 kg/m2. The mean surgical duration was 161.9±24.7 minutes and the mean blood loss was 134.4±95.9 ml. Surgical time (170 min vs 150 min) and per-op blood loss (120 mL vs 100 mL) were significantly higher in the APA (+) group compared with APA (-) group (p < 0.05). There was no significant (p>0.05) difference in the preop IIEF-5 scores in APA (-) and APA (+) groups but IIEF-5 scores in postop 3rd, 6th, 12th and 18th months were significantly higher (p<0.05) in the APA(+) group compared to APA(-) group. No significant decrease was detected in IIEF-5 scorse in the postop follow-ups in either group (p<0.05).Conclusions: In this study, we showed that APA presence is an important factor in the preservation of sexual function and if APAs are detected, preservation of this arterial structure should be among the steps of RALP.

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“…In a retrospective clinical study, Park, et al suggested a possible connection between APA preservation and postsurgical functional outcome [ 5 ]. The radiology literature describing the identification of APAs with incidence and anatomy is limited, though they have been described on CT images [ 17 , 19 ]. However, MRI involves no radiation and can provide more accurate information for the determination of pelvic soft tissues.…”

Section: Discussionmentioning

confidence: 99%

Development of a Three-dimensional Surgical Navigation System with Magnetic Resonance Angiography and a Three-dimensional Printer for Robot-assisted Radical Prostatectomy

Jomoto¹,

Tanooka²,

Doi³

et al. 2018

Cureus

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We sought to develop a surgical navigation system using magnetic resonance angiography (MRA) and a three-dimensional (3D) printer for robot-assisted radical prostatectomy (RARP). Six patients with pathologically proven localized prostate cancer were prospectively enrolled in this study. Prostate magnetic resonance imaging (MRI), consisting of T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE) and true fast imaging with steady-state precession (true FISP), reconstructed by volume rendering, was followed by dynamic contrast-enhanced MRA performed with a volumetric interpolated breath-hold examination (VIBE) during intravenous bolus injection of gadobutrol. Images of arterial and venous phases were acquired over approximately 210 seconds. Selected images were sent to a workstation for generation of 3D volume-rendered images and standard triangulated language (STL) files for 3D print construction. The neurovascular bundles (NVBs) were found in sequence on non-contrast images. Accessory pudendal arteries (APAs) were found in all cases in the arterial phase of contrast enhancement but were ill-defined on non-contrast enhanced MRA. Dynamic contrast-enhanced MRA helped to detect APAs, suggesting that this 3D system using MRI will be useful in RARP.

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Pelvic magnetic resonance imaging angioanatomy of the arterial blood supply to the penis in suspected prostate cancer patients

Cited by 12 publications

References 22 publications

Post-Traumatic High-Flow Priapism: Accessory Pudendal Origin of Cavernosal Artery From External Iliac Artery - A Case Report

Post-Traumatic High-Flow Priapism: Accessory Pudendal Origin of Cavernosal Artery From External Iliac Artery - A Case Report

Robot-Assisted Radical Prostatectomy: Accessory Pudendal Arteries Preservation and Effects on Sexual Functions

Development of a Three-dimensional Surgical Navigation System with Magnetic Resonance Angiography and a Three-dimensional Printer for Robot-assisted Radical Prostatectomy

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