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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, also called venogenic erectile dysfunction and penile venous insufficiency, is one category of vascular-induced (vasculogenic) impotence – a cause of erectile dysfunction in males. [2] It affects all ages, being particularly awkward in young men. [ 3 ]
Erectile dysfunction (ED), also referred to as impotence, is a form of sexual dysfunction in males characterized by the persistent or recurring inability to achieve or maintain a penile erection with sufficient rigidity and duration for satisfactory sexual activity.
An erection (clinically: penile erection or penile tumescence) is a physiological phenomenon in which the penis becomes firm, engorged, and enlarged. Penile erection is the result of a complex interaction of psychological, neural, vascular, and endocrine factors, and is often associated with sexual arousal, sexual attraction or libido, although erections can also be spontaneous.
Delay in seeking treatment increases the complication rate. Non-surgical approaches result in 10–50% complication rates including erectile dysfunction, permanent penile curvature, damage to the urethra and pain during sexual intercourse, while operatively treated patients experience an 11% complication rate. [4] [12]
Blood can leave the erectile tissue only through a drainage system of veins around the outside wall of the corpus cavernosum. The expanding spongy tissue presses against a surrounding dense tissue (tunica albuginea) constricting these veins, preventing blood from leaving. The penis becomes rigid as a result.
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