Arteriovenous fistula combined with basal external penile compression: a new cure for male impotence

We describe here a new procedure designed to enable reproducible sustained erection in a canine model. In 10 dogs, an end-to-side arteriovenous fistula was created between the inferior epigastric artery and deep dorsal vein. A chronic skin tunnel was created at the penile base. Blood flow, intracavernosal pressure and intraspongiosal pressure and blood gases were measured initially and 3 months later. Cuff application for 30 minutes was used daily. At 3 months, animals were sacrificed and biopsies obtained. Physiologic and histological parameters of erectile structures remained unchanged. Intracavernosal and intraspongiosal pressures increased to 33.7 +/- 6.7 mm Hg and 25.3 +/- 12.2 mm Hg (from 8.0 +/- 2.9 and 6.0 +/- 3.6 mm Hg) after cuff application. We conclude that sustained erections are feasible. This procedure appears safe for human trials.