1804 PENILE REVASCULARIZATION IN VASCULOGENIC ERECTILE DYSFUNCTION: LONG-TERM FOLLOWUP

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Peyronie's Disease/Surgical Therapy1 Apr 20111804 PENILE REVASCULARIZATION IN VASCULOGENIC ERECTILE DYSFUNCTION: LONG-TERM FOLLOWUP Onder Kayigil, Emrah Okulu, Mustafa Aldemir, and Efe Önen Onder KayigilOnder Kayigil Ankara, Turkey More articles by this author , Emrah OkuluEmrah Okulu Ankara, Turkey More articles by this author , Mustafa AldemirMustafa Aldemir Ankara, Turkey More articles by this author , and Efe ÖnenEfe Önen Ankara, Turkey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2176AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Penile revascularization(PR) in vasculogenic erectile dysfunction represents a physiologic attempt to restore erection, and it is the only causal therapy for erectile failure. Patient selection is the most important factor for the best outcome and long-term success of after penile arterial revascularization. This study aim to determine the overall long-term success of PR and to investigate the effect of risk factors on the results of modified Furlow-Fisher technique. METHODS Between 1997 and 2008, 125 patients with an average age of 43.2 years underwent penile revascularization surgery. A total of 110 patients completed the long-term follow-up with a mean follow-up of 73.2 months. Diagnostic evaluations, penile color Doppler ultrasonography, CC-EMG, and cavernosometry, were performed in all the patients preoperatively. All the patients were asked to answer a 15-item questionnaire IIEF pre and postoperatively. The findings on all five domains of the IIEF were recorded. The efficacy of the operation was assessed as improvement or failure according to the change in the five-item version of the IIEF (IIEF-5). At least five points of increase in the IIEF-5 score during the latest patient visit in the postoperative period compared with the preoperative period was regarded as improvement (surgical success). Other results were regarded as failure. RESULTS The mean total IIEF score was 30.1±7.7 before the operation, and it was 45.3 ± 10.3 at the end of the follow-up (p<0.05). The mean IIEF-5 score was 7.3 ± 3.2 before the operation, and it was 16.8 ± 3.1 at the end of the follow-up (p<0.05). Preoperatively, the mean erectile function domain score was 10.9 ± 4.4, and it was 18.09 ± 8.1 at the end of the follow-up (p<0.05). The success rates were 81.8% in 3-month, 77.2% in 1-year, 70% in 2- year, 66.3% in 3-year and 63.6% in 5-year follow-up in the patients who achieved a no-ED cut off score >26 in IIEF-15. The success rate was the highest in the patients with arteriogenic insufficiency (77.7%). The success rate was the highest in the group of patients with no risk factors (92.8%). Early postoperative thrombosis of anastomosis was determined in 6 patients (5.45%), and incisional hernia was observed in 5 patients (4.54%). Seven patients (6.36%) showed signs of glans hypervascularization as a major complication. CONCLUSIONS PR operations have not been widely used by urologists due to the technical difficulties and phosphodiesterase inhibitors. However, reported high rates of noncompliance or failure of oral pharmacotheraphy seems likely to increase this operation's popularity in the near future. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e724-e725 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Onder Kayigil Ankara, Turkey More articles by this author Emrah Okulu Ankara, Turkey More articles by this author Mustafa Aldemir Ankara, Turkey More articles by this author Efe Önen Ankara, Turkey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...