Objective: To restore physiological erection by performing microsurgical penile revascularization.
Patients and methods: The records of 21 patients with pure arteriogenic impotence were reviewed. Thirteen patients with localized obstruction of the internal pudendal or common penile artery underwent a Michal II arterio-arterial penile revascularization. Eight patients with a more distal arterial obstruction underwent a penile deep dorsal vein arterialization (DDVA). The mean follow-up period was 22 months. Surgery was considered successful when the patients had a permeable anastomosis and were able to achieve satisfactory erections resulting in normal intercourse.
Results: Potency was restored in eight of the 13 patients who had a Michal II procedure and in five of the eight patients who had a DDVA. Under antithrombotic therapy graft occlusion occurred in four patients.
Conclusion: Microsurgical penile revascularization restored erectile function in two-thirds of patients in this study. However, further research must be performed to reach a greater understanding of the revascularization process.