Penile Revascularization in Nonresponders to Intracavernous Injections Using a Modified Microsurgical Technique

Löbelenz, M.; Kp, Jünemann; Ku, Köhrmann; Seemann, O.; Rassweiler, Jens; Tschada, R.; Alken, P.

doi:10.1159/000474816

Cited by 21 publications

(12 citation statements)

References 6 publications

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“…Cookson 17 con®rmed the insuf®ciency of arterial bypass to treat mixed vasculogenic impotence patients, while other authors reported similar success rates to ours with DDVA. 2,14,16 DDVA is the most effective procedure to restore erection, our results have been con®rmed by other studies. 2,6,14±16,18,24,29,42 Nevertheless, the hemodynamic consequences of this operation are still controversial.…”

Section: Discussionsupporting

confidence: 84%

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Microrevascularisation of the penis in vascular impotence

Bertrand

Malavaud

et al. 1997

Int J Impot Res

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Purpose: We evaluated the results of microvascular penile revascularization in impotent men and carefully selected those whose vasculogenic impotence was de®ned as arteriogenic impotence, veno-cavernous leakage or mixed vasculogenic impotence. Materials and methods: Over a period of 11 y, 114 patients were treated for vasculogenic impotence with two surgical procedures: Michal II arterial bypass (44 patients) and modi®ed Furlow±Fisher technique of deep dorsal vein arterialization (DDVA) (70 patients). Initial evaluation included history, physical and neurological examination, hormonal level determination, pharmacological erection test, Rigiscan, duplex ultrasonography, selective pudendal arteriography, dynamic cavernosometry and cavernosography. The patients were followed up for a mean period of 17 months and the results were clinically evaluated. Results: The results at the end of one month were considered as good in 69.5% and improved in 12.2% and failed in 18.3%. Follow-up results are good in 47.8%, improved in 14.6% and failed in 37.4%. The best success rate was obtained with patients with pure venogenic impotence treated with DDVA, whereas the worst was observed in patients with pure arteriogenic impotence treated with the Michal II procedure. DDVA seems to provide better results than arterial bypass regardless of the etiology of impotence. Conclusions: Penile microvascular revascularization is not the best cure for all impotent men but appears to have a place in the treatment for selected patients with vasculogenic impotence. Further studies will be necessary to de®ne parameters able to permit a better understanding and selection of candidates.DDVA is the most effective procedure to treat surgically vasculogenic impotence although the hemodynamic and biologic consequences of this operation are unknown.

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Section: Discussionsupporting

confidence: 84%

“…43 The main complication of this procedure is glandular hypervascularisation, whose frequency is evaluated between 5±22%. 14,44 However, in our experience, this complication can be successfully treated by reduction of the blood¯ow into the graft, without impairment of potency.…”

Section: Discussionmentioning

confidence: 82%

Microrevascularisation of the penis in vascular impotence

Bertrand

Malavaud

et al. 1997

Int J Impot Res

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“…32) by some authors [27]. We do not consider it an improvement; on the contrary, the flow undergoes disturbances by the turbulences thus created.…”

Section: Survey Of the Different Surgical Concepts For The Treatment mentioning

confidence: 78%

A critical Review of Penile Revascularization Procedures

Hauri

1998

Urol Int

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“…Penile arterialization by deep dorsal vein-inferior epigastric artery anastomosis is an operation performed to treat some types of arteriogenic or venogenic impotence [1,2]. The most common complication of such a procedure is penile hypervascularization [3].…”

Section: Discussionmentioning

confidence: 99%

“…Penile venous arterialization is a surgical treatment for selected cases with erectile dysfunction [1,2]. However, this procedure, especially when performed on overdiagnosed patients, may result in glandular hypervascularization [3].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Management of Ulcerative Glandular Hypervascularization after Virag-I Operation

Peşkircioğlu

Tekin²,

Boyvat³

et al. 2001

Urol Int

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A 42-year old man was admitted with glans ulcer, meatal stenosis, urinary retention and impotence. He had undergone a Virag-I operation because of impotence at another hospital 2 months earlier. The deep dorsal vein was isolated under local anesthesia and blocked by coils and embolized by n-butyl cyanoacrylate in a retrograde fashion. After 2 months, the glans had healed completely. The patient has no further urinary problem and is potent.

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Penile Revascularization in Nonresponders to Intracavernous Injections Using a Modified Microsurgical Technique

Cited by 21 publications

References 6 publications

Microrevascularisation of the penis in vascular impotence

Microrevascularisation of the penis in vascular impotence

A critical Review of Penile Revascularization Procedures

Percutaneous Management of Ulcerative Glandular Hypervascularization after Virag-I Operation

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