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Conditions: Erectile Dysfunction

Vascular Surgery - Erectile Dysfunction

What form of patient evaluation is required?

All patients considered candidates for penile revascularization should have a routine hormone evaluation to ensure adequate circulating levels of testosterone. In addition, a nocturnal penile tumescence and rigidity analysis (NPTR) should be performed to rule out neurogenic and psychogenic erectile dysfunction. Finally, a blood flow assessment with duplex Doppler penile ultrasonography or dynamic infusion cavernosometry/cavernosography (DICC) is required. Following testing, if the patient has a diagnosis of pure arterial insufficiency, an arteriogram is performed to show the arterial anatomy and confirm the location of the blockage. The arteriogram should demonstrate several findings to ensure optimal results from penile revasularization. These findings include: 1) a blockage of the common penile or cavernosal artery at a point that is amenable to bypass 2) at least one donor (inferior epigastric) artery of sufficient length and caliber to reach the top surface of the penis and the recipient artery 3) communicating branches passing from the dorsal artery into the erection chamber (corpus cavernosum) on at least one side, preferably the side of the occlusion.


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