Document Detail


Outcome of penile revascularization for arteriogenic erectile dysfunction after pelvic fracture urethral injuries.
MedLine Citation:
PMID:  23206787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review our experience with penile revascularization for patients with bilateral occlusion of the deep internal pudendal arteries after pelvic fracture urethral injury (PFUI).
MATERIALS AND METHODS: We identified 17 patients who had undergone penile revascularization with end-to-side anastomosis of the deep inferior epigastric artery to the dorsal penile artery from July 1991 to December 2010. Success was defined as achieving erections sufficient for intercourse with or without pharmacologic assistance.
RESULTS: All patients had had a PFUI causing arterial insufficiency and erectile dysfunction not responsive to pharmacologic intervention. Of the 17 patients, 4 (24%) underwent revascularization before and 13 (76%) after PFUI repair. The mean age at revascularization was 32.7 years (range 17-54). At an average follow-up of 3.1 years, the surgery was successful in 14 of the 17 patients (82%). In patients with erectile dysfunction as an indication for surgery, successful erections were achieved in 11 of 13. For those who underwent revascularization to prevent ischemic stenosis of the urethral repair, 3 of 4 achieved successful erections, and all subsequent urethral surgeries were successful. The penile duplex ultrasound parameters showed clinically and statistically significant improvements after revascularization. No operative complications developed. The average hospital length of stay was 4.7 days. Four patients experienced early postoperative complications, including an abdominal wall hematoma requiring evacuation in one, penile edema in two, and a superficial surgical site infection in one. No late complications occurred.
CONCLUSION: Penile arterial revascularization in select patients can allow for successful treatment of PFUIs and the refractory erectile dysfunction caused by them.
Authors:
Jack M Zuckerman; Kurt A McCammon; Britton E Tisdale; Larry Colen; Ted Uroskie; Paul McAdams; Gerald H Jordan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Urology     Volume:  80     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-04     Completed Date:  2013-03-14     Revised Date:  2013-10-02    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1369-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, Eastern Virginia Medical School, Norfolk, Virginia 23502, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anastomosis, Surgical
Arterial Occlusive Diseases / etiology*,  surgery*
Epigastric Arteries / surgery
Humans
Impotence, Vasculogenic
Male
Middle Aged
Penis / blood supply*,  injuries*
Retrospective Studies
Rupture
Urethra / injuries*
Young Adult
Comments/Corrections
Comment In:
Urology. 2012 Dec;80(6):1373-4   [PMID:  23206788 ]
J Urol. 2013 Jun;189(6):2168   [PMID:  23663613 ]
J Urol. 2013 Sep;190(3):935-6   [PMID:  23931202 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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