Vascular surgery for impotence: a review

Progress in treatment of impotence in the past two decades has resulted in impressive advances. While most men respond to medical therapy including prostaglandin E1 injection or the more recent use of urethral alprostadil, 6-7% of men fail to respond to these treatments or vacuum devices. This review considers current and past results of vascular surgery in this group of men. Guidelines for case selection for vascular interventions as well as reporting criteria are suggested. Vascular surgery as a logical first step in selected patients may offer an advantage in men failing conservative therapy and for those not desiring prosthetic implantation.