Indications

Surgery is indicated in cases of organic impotence not amenable to non-surgical treatments and in psychogenic impotence where conventional psychotherapy has failed repeatedly.

• Prosthetic Surgery
• Two major categories: malleable or semirigid and the inflatable devices

Vascular Procedures

• Proximal arterial lesions
• Direct iliac to hypogastric artery graft
• Hypogastric endarterectomy
• Transluminal balloon angioplasty
• Distal arterial lesions.
• Neoartery to cavernosal anastamosis (complications include priapism and corporal fibrosis)
• Neoarte-rial anastomosis to the dorsal artery, cavernosal artery, or dorsal vein of the penis
• Venous lesions

References

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• Dinsmore W, Evans C: ABC of sexual health: Erectile dysfunction. Br Med J 318:387-390, 1999.
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• Goldstein 1: Current status of surgical correction of vasculogenic impotence. In Lytton B, Catalona WJ, Lipshultz LL eds. Advances in Urology, vol. 7, St. Louis, Mosby, 1994, p 155.
• Arterial revascularization procedures. Semin Urol 4:252, 1986.
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