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Alexander Balko, MD; Chander M. Malhotra, MD; John P. Wincze, PhD; Jacques G. Susset, MD; Sudhir Bansal, MD; Wilfred I. Carney, MD; Robert W. Hopkins, MD

Arch Surg. 1986;121(7):774-777.

Abstract
• Eleven impotent men underwent deep-penile-vein arterialization after preoperative assessment by a multidisciplinary team. Penile Doppler pressures, testosterone levels, and nocturnal penile tumescence were used to establish a vasculogenic etiology. Cavernosography, artificial erection by saline infusion, and selective hypogastric arteriography were obtained to delineate whether arterial, venous, or mixed (arterial/venous) factors predominated. Penile revascularization consisted of femoral artery to deep-penile-vein saphenous bypass, with ligation of superficial veins at the base of the penis in patients with venous leakage. Cumulative graft patency was 91% up to 20 months. There were no deaths. The average preoperative flow requirement of values greater than 250 mL/min was reduced to 59 mL/min postoperatively. Follow-up results of nocturnal penile tumescence were excellent in four of four patients with venous (venous leakage), two of three patients with arterial, and one of four patients with mixed factors. Deep-penile-vein arterialization appears to be beneficial for impotence secondary to venous leakage, with inconsistent results for arterial and mixed factors.

(Arch Surg 1986;121:774-777)

Author Affiliations
From the Departments of Vascular Surgery (Dr Balko), Radiology (Dr Malhotra), Psychology (Dr Wincze), Urology (Dr Susset), and Endocrinology (Dr Bansal), Providence Veterans Administration Medical Center, Providence, RI; and the Departments of Vascular Surgery, Rhode Island Hospital (Dr Carney) and Miriam Hospital (Dr Hopkins), Providence, RI.

Footnotes
Accepted for publication Jan 3, 1986.

Read before the 12th Annual Meeting of the New England Society for Vascular Surgery, Whitefield, NH, Oct 11, 1985.

Reprint requests to Surgical Service (112), Providence Veterans Administration Medical Center, Davis Park, Providence, RI 02908 (Dr Balko).

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