[Digital angiography of the pudendal arteries in erectile impotence]

Digital angiography of pudendal and penile arteries was performed on 32 consecutive patients with erectile failure of suspected vascular origin. Intra-arterial injection of contrast medium via selective catheterization of the hypogastric arteries was used in 6 cases. In 27 cases, one of which already submitted to arterial catheterism, the intravenous route was employed for contrast administration, using a single, large volume, high speed bolus. In one case, digital angiography was diagnostically unreliable due to patient's motion and to blurring artifacts. Among the remaining cases, 9/31 (29%) showed a normal angiographic picture, while 22/31 (71%) possessed stenotic-obstructive lesions of different severity. The pictures obtained after intravenous contrast administration were diagnostically equivalent to those obtained with arterial catheterism: in addition, intravenous route allowed the simultaneous representation of the arterial network of both sides and the overall examination resulted less invasive and quicker. In 22/32 patients (69%), functional determinations of erectile capability and of penile blood flow were performed for comparison. Nocturnal penile tumescence (12 cases diagnostically useful) was well correlated with the angiographic picture. Penile blood flow measurements with the Doppler technique (21 cases) seemed on the contrary to be less sensitive than digital angiography.