Early Experience of Penile Revascularization Procedure with Anastomosis of Inferior Epigastric Artery to Dorsal Penile Artery in Arteriogenic Impotent Patients / 대한비뇨기과학회지

ABSTRACT

PURPOSE: We report the results of a penile revascularization procedure of the inferior epigastric artery to the dorsal penile artery in arteriogenic impotent patients. MATERIALS AND METHODS: Microvascular arterial bypass surgery was performed in 5 impotent patients (age 29-40, mean 35 years) in order to treat a cavernosal arterial insufficiency secondary to focal occlusive disease in cavernosal arteries. The surgical procedure was performed on an end-to-side anastomosis of the inferior epigastric artery to the dorsal penile artery. The erectile function was evaluated by the International Index of the Erectile Function questionnaire (IIEF) and penile duplex Doppler ultrasonography before and 6 weeks after surgery. RESULTS: The IIEF score improved in 4 of 5 patients postoperatively. Penile arterial peak systolic velocity (PSV) had improved significantly from 21.4+/-2.2cm/sec to 33.7+/-9.6cm/sec in the right side, from 18.5+/-6.8cm/sec to 36.0+/-10.0cm/sec in the left (p< 0.05), respectively. There were no serious adverse effects of the surgery except for one patient who had a hematoma at the vascular anastomotic site. CONCLUSIONS: A penile revascularization procedure of the inferior epigastric artery to the dorsal penile artery is an effective surgical method for correcting an arteriogenic erectile dysfunction with a normal corporeal veno-occlusive mechanism.