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LONG-TERM FOLLOWUP AND SELECTION CRITERIA FOR PENILE REVASCULARIZATION IN ERECTILE FAILURE

1998; Lippincott Williams & Wilkins; Volume: 160; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(01)62382-6

1527-3792

Martina Manning, Klaus‐Peter Jünemann, Jeroen R. Scheepe, Peter Braun, A. Krautschick, P. Alken,

Genital Health and Disease

No AccessJournal of UrologyClinical Urology: Original Articles1 Nov 1998LONG-TERM FOLLOWUP AND SELECTION CRITERIA FOR PENILE REVASCULARIZATION IN ERECTILE FAILURE MARTINA MANNING, KLAUS-PETER JUNEMANN, JEROEN R. SCHEEPE, PETER BRAUN, ANDREAS KRAUTSCHICK, and PETER ALKEN MARTINA MANNINGMARTINA MANNING , KLAUS-PETER JUNEMANNKLAUS-PETER JUNEMANN , JEROEN R. SCHEEPEJEROEN R. SCHEEPE , PETER BRAUNPETER BRAUN , ANDREAS KRAUTSCHICKANDREAS KRAUTSCHICK , and PETER ALKENPETER ALKEN View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62382-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report the long-term results of penile revascularization surgery for erectile failure and suggest possible selection criteria for this controversial surgical procedure. Materials and Methods: In 7 years 62 impotent men who did not respond to pharmacotherapy underwent microsurgical penile revascularization and completed long-term followup evaluation in 41 months (range 18 to greater than 62) consisting of a detailed questionnaire, duplex sonography and optional pharmacotherapy or angiography. The Virag procedure was chosen for the first 7 patients, the original Hauri technique for the next 13 and the modified Mannheim triple anastomosis for 42. Results: Of all patients 34% achieved spontaneous and another 20% pharmacologically induced erections. Success in diabetics and older patients was lower (43% for diabetics, 39% for those older than 50 years at surgery), while it was high in men with less than 2 risk factors (58%) as well as in younger patients (69% for those up to 50 years old). Shunt patency was 92%. Complications such as glans hyperemia developed in 13% of patients, shunt thrombosis in 8% and inguinal hernias in 6.5%. Conclusions: Patient selection is vital for the successful outcome of penile revascularization surgery. We adhere to strict selection criteria, such as patient age maximum of 50 years, less than 2 risk factors, no recent diabetes and termination of nicotine abuse. Penile revascularization surgery is highly indicated in this group of patients, especially since it is the only causal therapy for erectile failure. References 1 : Pharmakotherapie der Erektionsstorungen nach Operationen im kleinen Becken. Urol.1990; 29. Google Scholar 2 : High attrition rate with intracavernous injection of prostaglandin E1 for impotency. Urology1994; 43: 84. Google Scholar 3 : Objective criteria in the long-term evaluation of penile venous surgery. J. Urol.1994; 152: 888. Link, Google Scholar 4 : Safety and efficacy outcome of Mentor Alpha 1 inflatable penile prosthesis implantation for impotence treatment. J. Urol.1997; 157: 833. 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Google Scholar From the Department of Urology, Klinikum Mannheim of the University of Heidelberg, Mannheim, Germany© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySIROKY M and AZADZOI K (2018) Vasculogenic Erectile Dysfunction: Newer Therapeutic StrategiesJournal of Urology, VOL. 170, NO. 2S, (S24-S30), Online publication date: 1-Aug-2003.SIMOPOULOS D, GIBBONS S, MALYSZ J, SZURSZEWSKI J, FARRUGIA G, RITMAN E, MORELAND R and NEHRA A (2018) CORPOREAL STRUCTURAL AND VASCULAR MICRO ARCHITECTURE WITH X-RAY MICRO COMPUTERIZED TOMOGRAPHY IN NORMAL AND DIABETIC RABBITS: HISTOPATHOLOGICAL CORRELATIONJournal of Urology, VOL. 165, NO. 5, (1776-1782), Online publication date: 1-May-2001. Volume 160Issue 5November 1998Page: 1680-1684 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information MARTINA MANNING More articles by this author KLAUS-PETER JUNEMANN More articles by this author JEROEN R. SCHEEPE More articles by this author PETER BRAUN More articles by this author ANDREAS KRAUTSCHICK More articles by this author PETER ALKEN More articles by this author Expand All Advertisement PDF downloadLoading ...