Penile revascularisation for vascular impotence

Many methods of microscopic penile revascularisation procedures have been employed over the past 2 decades for the treatment of vasculogenic impotence, with varying success rates. The aim of our study was to evaluate the effectiveness and complications of deep dorsal vein arterialisation in the treatment of selected patients with arteriogenic and mixed arteriogenic/venogenic impotence.

This involved a retrospective analysis of 6 patients with vasculogenic impotence who presented to Toa Payoh Hospital from December 1991 to November 1994 and had penile revascularisation surgery performed. All patients underwent an extensive preoperative assessment, including dynamic infusion cavernosometry and cavernosography and selective pudendal arteriography.

The 6 patients were aged between 27 and 51 years (mean 44 years). 2 (33%) patients had pure arteriogenic impotence, while 4 (66%) had mixed arteriogenic and venogenic impotence. Two patients (33%) had excellent surgical outcomes and 2 patients (33%) were considered improved. The mean follow-up period was 19.8 months (range 8 to 37). Complications were minimal.

We conclude that although the results of penile revascularisation are promising in carefully selected patients, further studies with longer follow-up and more objective postoperative tests of hemodynamic and erectile function are needed to assess the true value of this mode of treatment.