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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.
Penile plethysmography (PPG) or phallometry is a measurement of blood flow to the penis, typically used as a proxy for measurement of sexual arousal.The most commonly reported methods of conducting penile plethysmography involves the measurement of the circumference of the penis with a mercury-in-rubber or electromechanical strain gauge, or the volume of the penis with an airtight cylinder and ...
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.
These waves break down any plaques within the blood vessels, encourage the formation of new vessels, and stimulate repair and tissue regeneration. [57] [58] Focused shockwave therapy appears to work best for males with vasculogenic ED, which is a blood vessel disorder that affects blood flow to tissue in the penis.
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 ]
Blood gas testing the blood from the cavernosa of the penis can help in the diagnosis. [3] If the low-flow type of priapism is present, the blood typically has a low pH, while if the high-flow type is present, the pH is typically normal. [3] Color Doppler ultrasound may also help differentiate the two. [3]
Other symptoms include severe pain, loss of erection, and swelling. [5] Symptoms of urethral injury include hematuria, blood at the meatus, and dysuria. [1] If left untreated, complications result in 28–53% of cases; these include permanent curvature of the penis, fistula, urethral diverticulum, priapism, and erectile dysfunction. [5]