EVALUATION OF MICROSURGICAL PENILE REVASCULARIZATION IN TREATMENT OF VASCULOGENIC ERECTILE DYSFUNCTION

Abstract

Aim of work: In this study we evaluate microsurgical penile revascularization as a treatment option for crecti lc dysfunction & try to suggest certain selection criteria for patients who are candidates for this surgery.

Pati.ents & Methods: We selected ten patients, complaining of vasculogenic erectile dysfunction, less than 55 years of age, having less than two risk factors of atherosclerosis to do for them microsurgical penile revascularization. All patients were evaluated preoperatively by sexual functionquestionnaire & subjected to pre perative rigiscan, intracorporeal injection test, penile Doppler, dynamic infusion cavernosometry & cavernosography, internal pudendal arteriography. After surgery the erectile function was assessed by intracorporeal injetion test & the anastomotic patency was evaluated by penile Doppler & inferior epigastric angiography.

Results: The overall success rate was 80% in the form of: 60% of patients restored spontaneous erectile li.1nction .& 20% with the aid of intracorporeal injection of vasoactive agent. All of these patients showed patent anastomosis post-operatively by penile Doppler & inferior epigastric mieriography. The remaining 20% of patients failed to regain the erectile function & objective data contirmed presence of occlusion at the anastomotic site.

Conclusion: Patient selection IS important for the successful outcome. We recommend selection criteria of vasculogenic erectile dysfunction, age younger than 50 years, less than 2 risk factors of atherosclerosis (diabetes, hypertension, ischemic heart disease, smoking, hypercholesterolemia, alcoholism). Penile revascularization is highly