Arterial epigastricocavernous anastomosis for the treatment of sexual impotence

Abstract

Abstract Previous histologic and phalloarteriographic studies that we have performed suggest that stenoses and occlusions of the arteries supplying the penis play a very important role in the etiology of sexual impotence in many patients. This report describes the results of direct arterial anastomosis to the cavernous bodies of the penis, using the inferior epigastric artery and microsurgical technique, in 21 impotent males ranging in age from 40 to 63 years. The objective of the operation was to increase basal penile blood flow to a level, determined by preoperative studies, just below that necessary to maintain an effective erection. A limited capacity to increase blood flow in response to an erotic stimulus could then suffice to produce an erection. The anastomosis became occluded in 6 patients, and the complication of priapism developed in 3. The bypass remained patent in 13 patients, 11 of whom experienced improved erection. Nine patients resumed normal sexual activity that, prior to operation, was impossible .