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Penile revascularization is a specialized vascular-surgical treatment option for erectile dysfunction. The 2009 International Consultation on Sexual Dysfunctions recommended that revascularization be limited to nonsmoker, nondiabetic men younger than 55 years of age with isolated stenosis of the internal pudendal artery with absence of venous leak. [1]
Venous leak is an inability to maintain an erection in the presence of sufficient arterial blood flow through the cavernosal arteries of the penis. [6] The defect lies in the excessive drainage of veins in the cavernosal tissue of the penis, which undermines normal erectile function.
Arteries and veins of the penis. The penile artery (also known as the common penile artery) is the artery that serves blood to the penis. It is a terminal branch of the internal pudendal artery, along with the scrotal artery. It subdivides into three arteries, the bulbourethral artery, the dorsal artery of the penis and the cavernosal artery.
In the male varicocele, this plexus of veins drains blood from the testicles back to the heart. The vessels originate in the abdomen and course down through the inguinal canal as part of the spermatic cord on their way to the testis. Varicoceles occur in around 15% to 20% of all men. [3] [4] The incidence of varicocele increase with age.
When a large amount of blood flows to the genital region, the penis becomes erect and the testicles also experience increased blood flow and swelling. [4] In the vulva, the blood flow increases in erectile tissue, causing it to expand. After orgasm, the tissue shrinks back to its initial size as most of the blood leaves.
The dorsal arteries of the penis are located adjacent to the deep dorsal vein and a cavernous artery is located in the center of each corpus cavernosum. On color Doppler, the cavernous arteries present single phase flow. In the flaccid penis (Figure 3), the normal cavernous arteries show a systolic peak between 11 and 20 cm/s.
Arterial occlusion is a condition involving partial or complete blockage of blood flow through an artery. Arteries are blood vessels that carry oxygenated blood to body tissues. [ 1 ] [ 2 ] An occlusion of arteries disrupts oxygen and blood supply to tissues, leading to ischemia . [ 1 ]
The signs and symptoms of ischemia vary, as they can occur anywhere in the body and depend on the degree to which blood flow is interrupted. [4] For example, clinical manifestations of acute limb ischemia (which can be summarized as the "six P's") include pain, pallor, pulseless, paresthesia, paralysis, and poikilothermia.