Revascularization in Erectile Dysfunction due to Pelvic Trauma

Year 2019, Volume: 21 Issue: 2, 148 - 150, 30.08.2019

Alpaslan Yüksel Okay Güven Karaca Dursun Baba Yusuf Şenoğlu Ali Tekin

https://doi.org/10.18678/dtfd.585921

Cited By: 1

Abstract

Erectile dysfunction is defined as the inability to achieve penile erection necessary for sexual intercourse or to sustain erection sufficiently. Although the treatment options for erectile dysfunction are limited, the most common surgical treatment is penile prosthesis implantation. In addition, penile revascularization of the penis is very effective in the treatment of erectile dysfunction due to different vasculogenic reasons, especially pudendal artery occlusion, after perineal trauma. Modified Furlow Fisher technique including anastomosis of the inferior epigastric artery to the penile dorsal vein is a successful treatment option among the revascularization techniques. Despite invasive preliminary evaluations such as duplex Doppler ultrasound, dynamic cavernosometry, selective internal pudendal arteriography, and the long and difficult surgical procedure, it is highly effective in particularly selected young patients.

Keywords

Erectile dysfunction, revascularization, pelvic trauma

Pelvik Travma Sonrası Oluşan Erektil Disfoksiyonda Revaskülarizasyon

Abstract

Erektil disfonksiyon, cinsel ilişki için gerekli olan penil sertleşmeyi sağlayamamak veya ereksiyonu yeterince sürdürememek olarak tanımlanır. Erektil disfonksiyon ile ilgili tedavi seçenekleri sınırlı olmakla birlikte en sık başvurulan cerrahi tedavi yöntemi penil protez implantasyonudur. Bunun yanında vasküler hastalık olmaksızın perineal travma sonrası, başta pudental arter oklüzyonu olmak üzere farklı vaskulojenik sebeplerle gelişen erektil disfonksiyon tedavisinde, penisin yeniden kanlandırılması için yapılan penil revaskülarizasyon ameliyatı oldukça etkilidir. İnferior epigastrik arterin penil dorsal vene anastomozunu içeren Modifiye Furlow Fisher tekniği revaskularizasyon teknikleri içerisinde başarılı bir tedavi seçeneğidir. Revaskularizasyon cerrahisi, dubleks Doppler ultrason, dinamik kavernosometri ve selektif internal pudendal arteriyografi gibi ön değerlendirmelere, cerrahi işlemin uzun ve zorluğuna rağmen özellikle uygun seçilmiş genç hastalarda oldukça etkilidir.

Keywords

Erektil disfonksiyon, revaskülarizasyon, pelvik travma

References

• McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, et al. Definitions of sexual dysfunctions in women and men: a consensus statement from the fourth international consultation on sexual medicine 2015. J Sex Med. 2016;13(2):135-43.
• Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633-41.
• Michal V, Kramár R, Pospíchal J, Hejhal L. Direct arterial anastomosis on corpora cavernosa penis in the therapy of erective impotence. Rozhl Chir. 1973;52(9):587-90.
• Virag R, Zwang G, Dermange H, Legman M, Penven JP. Investigation and surgical treatment of vasculogenic impotency. J Mal Vasc. 1980;5(3):205-9.
• Nene UA, Coyaji K, Apte H. Infertility: a label of choice in the case of sexually dysfunctional couples. Patient Educ Couns. 2005;59(3):234-8.
• Dicks B, Bastuba M, Goldstei I. Penile revascularization-contemporary update. Asian J Androl. 2013;15(1):5-9.
• Banai S, Shou M, Correa R, Jaklitsch MT, Douek PC, Bonner RF, et al. Rabbit ear model of injury-induced arterial smooth muscle cell proliferation. Kinetics, reproducibility, and implications. Circ Res. 1991;69(3):748-56.
• Furlow WL, Fisher J, Knoll LD. Penile revascularization experience with deep dorsal vein arterialization-the Furlow-Fisher modification with 27 patients. In: Proceedings of the Sixth Biennial International Symposium for Corpus Cavernosum revascularization and Third Biennial World Meeting on Impotence. Boston: International Society for Impotence Research (ISIR); 1988. p.139.
• Hauri D. A new operative technique in vasculogenic erectile impotence. World J Urol. 1986;4(4):237-49.
• Kawanishi Y, Kimura K, Nakanishi R, Kojima K, Numata A. Penile revascularization surgery for arteriogenic erectile dysfunction: the long-term efficacy rate calculated by survival analysis. BJU Int. 2004;94(3):361-8.
• Trost LW, Munarriz R, Wang R, Morey A, Levine L. External mechanical devices and vascular surgery for erectile dysfunction. J Sex Med. 2016;13(11):1579-617.