(315) Evidence Analysis for Contemporary Vascular Therapies for Erectile Dysfunction

Abstract

Abstract Introduction Erectile Dysfunction (ED) is a common male sexual disorder that is caused by various conditions including vascular dysfunction. Different treatment options can be implemented, like lifestyle modifications, pharmacological intervention, or surgical procedures. In select ED cases, vascular procedures such as penile revascularization and venous ligation could be an alternative option. Objective We herein evaluated the current evidence and outcomes of penile revascularization, venous ligation and other vascular surgery with specific emphasis on complications and patients’ satisfaction. Methods A literature search was conducted using PubMed and Google Scholar to examine papers from 1993 to present day. Keywords, such as, “Erectile dysfunction”, “ED vascular surgery”, “Penile venous ligation”, “Penile revascularization”, and “Arterial bypass surgery”, were used in this search. All the papers were in the English language. Results A total of four studies met inclusion criteria for penile arterial bypass and dorsal penile venous ligation procedures with erectile function, clinical outcomes, satisfaction rates and post operative complications. Regarding penile arterial bypass, two studies identified. First study reported inferior epigastric artery (IEA) to the penile dorsal artery of 1500 patients reported success rates of erectile function were 67% and satisfaction rates of 89%. Postoperative complications were anastomotic disruption, penile skin sensation loss and pain. Regarding venous ligation of penile dorsal vein, two studies identified. First study of 100 patients reported success rates of erectile function were 62% at 1 year. Second study of 26 patients reported success rates of erectile function were 42.3% and satisfaction rates of 57.7% at 3.7 years. Postoperative complications were painful erections, skin necrosis, and penile shortening (Table 1). Conclusions Vascular therapies including penile arterial bypass and penile dorsal venous ligation for ED could provide improved clinical outcomes and satisfactions in select patients’ population. Future studies are warranted to further evaluate its surgical outcomes and long-term safety and efficiency. Disclosure No.