[Revascularization of the penis in arteriogenic impotence. 10 years' experience]

From 1978 to 1987, various techniques have been used by the authors ECA (epigastrico-cavernous anastomosis) and its variants saphene ECA (prolonged by a vein), ECA + DDVL (used with ligature of the deep dorsal vein of the penis), finally FCA (femoro-cavernous anastomosis). According to the method of selection mode, "traditional" using arteriography and nocturnal erectometer; or "dynamic", completed with a flow-rate measurement, used with or without the papaverine test. Three groups of patients emerge corresponding to three periods: empirical surgery then functional surgery (+ flow-rate measurement), then improved (+ flow-rate measurement coupled with the papaverine test). The surgical sequelae are evaluated according to the level of success (G) total erections with normal relations improved (QG) reappearance of erections allowing relations; failure (B) relations impossible. The study concerns 91 patients with 83 experiencing long term success (92%) after more than one year. According to the techniques used the overall results (in improved patients) are: for FCA, 77% after three months (7/9 = 7 G) and 42 long term (3/7 = 3 G) for ECA 82% after three months (68/82 = 54 G + 14 QG) and 74% long term (49/76 = 40 G + 9 QG). According to the type of surgery, the results in improved patients are, all techniques combined: for empirical surgery (36 patients of which, 32 ACA, 2 saphene ECA and 2 FCA) 70% at three months and 48% long term, for improved functional surgery (22 patients with 12 ECA, 2 saphene ECA, 6 ECA + DDVL and 2 arteriolisations of the deep dorsal vein) 100% after three months and 72% long term.(ABSTRACT TRUNCATED AT 250 WORDS)