INTRAOPERATIVE ARTERIOGRAPHY FACILITATES PENILE REVASCULARIZATION

Penile revascularization via inferior epigastric dorsal penile artery bypass is a treatment option for men with vasculogenic impotence due t o proximal segmental arterial occlusion. Various diagnostic tests have been used to identify arterial vascular disease but pudendal arteriog raphy remains the gold standard anatomical study. Unfortunately, more than 80% of impotent men have significant variations in penile arteria l anatomy, and proximal arterial occlusions may prevent adequate visua lization of the intrapenile arteries. We have found that intraoperativ e penile arteriography performed through the dorsal penile artery faci litates the planning of the arterial anastomosis to ensure adequate bl ood flow to the corpora cavernosum. The indications and technique of i ntraoperative penile arteriography are described.