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Deep Dorsal Vein Arterialisation in Vascular Impotence
Author(s) -
WESPES E.,
CORBUSIER A.,
DELCOUR C.,
VANDENBOSCH G.,
STRUYVEN J.,
SCHULMAN C. C.
Publication year - 1989
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1989.tb05294.x
Subject(s) - medicine , papaverine , glans , tunica albuginea (penis) , surgery , penis , intracavernous injection , angiography , vein , dorsum , shunt (medical) , anatomy , anesthesia
Summary— A series of 12 patients with vasculogenic impotence (4 arterial lesions; 8 arterial and venous lesions) underwent deep dorsal vein arterialisation after pre‐operative assessment by a multidisciplinary approach. Cumulative graft patency was 58% (7 of 12 patients) up to 21 months but only 4 patients developed almost normal erections. Digital angiography, with and without the intracavernous injection of papaverine, was performed during follow‐up to determine the vascular physiological status. At flaccidity, the corpora cavernosa were never opacified in the absence of a venocorporeal shunt. The penile glans was always visualised. Opacification of the deep dorsal vein and the circumflex system decreased with penile rigidity, resulting from their compression between Buck's fascia and the tunica albuginea. Intracavernous pressure recorded before and after the surgical procedure showed a marked increase when a caverno‐venous shunt was performed. Hypervascularisation of the glans occurred in 2 cases. The relevance of this new surgical technique and its functional mechanism are discussed.