ANALYSIS OF MICROSURGICAL PENILE REVASCULARIZATION RESULTS BY ETIOLOGY OF IMPOTENCE

We reviewed the results of microsurgical penile revascularization, wit h or without a combined procedure to correct cavernosal venous leakage , in 50 consecutive patients with vasculogenic impotence. All patients underwent an extensive preoperative evaluation, including dynamic inf usion cavernosography and cavernosometry, and selective penile arterio graphy. Overall 48% (24 patients) had an excellent postoperative resul t, 40% (20 patients) were improved and 12% (6 patients) failed, with a median followup of 24 months (range 19 to 56). Furthermore, these res ults appear durable with no significant difference in length of follow up between groups irrespective of surgical outcome (p > 0.05). Analysi s of surgical outcomes by preoperative etiology of impotence (pure art erial versus arterial combined with corporeal venous dysfunction) reve aled a statistically significant advantage of an excellent surgical ou tcome in patients with pure arterial impotence compared to those with mixed etiology with results of 67% and 42%, respectively (p < 0.01). T here was no significant difference in outcome when patients were analy zed with respect to age or duration of impotence (p > 0.05). We conclu de that in patients with arteriogenic impotence identification of conc omitant corporeal veno-occlusive dysfunction diagnosed by preoperative dynamic infusion cavernosography and cavernosometry may be helpful, n ot only in planning a more physiological surgical procedure but also i n predicting long-term postoperative success.