MICROSURGICAL ARTERIO-ARTERIAL AND ARTERIOVENOUS PENILE REVASCULARIZATION IN PATIENTS WITH PURE ARTERIOGENIC IMPOTENCE

Objective To restore physiological erection by performing microsurgica l penile revascularization. Patients and methods The records of 21 pat ients with pure arteriogenic impotence were reviewed. Thirteen patient s with localized obstruction of the internal pudendal or common penile artery underwent a Michal II arterio-arterial penile revascularizatio n. Eight patients with a more distal arterial obstruction underwent a penile deep dorsal vein arterialization (DDVA). The mean follow-up per iod was 22 months. Surgery was considered successful when the patients had a permeable anastomosis and were able to achieve satisfactory ere ctions resulting in normal intercourse. Results Potency was restored i n eight of the 13 patients who had a Michal II procedure and in fine o f the eight patients who had a DDVA. Under antithrombotic therapy graf t occlusion occurred in four patients. Conclusion Microsurgical penile revascularization restored erectile function in two-thirds of patient s in this study. However, further research must be performed to reach a greater understanding of the revascularization process.