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Etat des traitements chirurgicaux de l’impuissance

Current status of surgical treatment for impotence

Abstract

The current status of the various surgical alternatives in the treatment of impotence is reviewed. Microsurgical techniques for arterial revascularization succeed in 70 to 87% of cases with a mean follow-up of 48 months. In cases of venous incompetence, arterialization of the deep dorsal vein gives the best, most long-lasting results. Penile prostheses have benefitted from continual technological advances with inflatable prostheses providing the best cosmetic appearance. Mechanical failures are now rare, but the cost of prostheses remain high. Vascular surgery continues to be the first option by virtue of its being physiological, and not compromising other procedures such as self-administered injections, vacuum or penile prostheses.

Resume

Mise au point actualisée des différentes possibilités chirurgicales pour traiter l’impuissance en 1991. Les techniques de revascularisation artérielle microchirurgicales donnent entre 70 et 87% d’excellents résultats avec des reculs de plus de 3 ans. Pour la pathologie veineuse, il semble que l’artérialisation de la veine dorsale profonde donne les meilleurs résultats et les plus durables. Les prothèses péniennes bénéficient des progrès constants de la technologie, les prothèses gonflables sont les mieux tolérées, les défauts mécaniques sont actuellement rares, mais leur prix demeure élevé. La chirurgie vasculaire doit toujours être tentée en priorité, car elle est physiologique, et ne compromet pas les autres procédés: auto-injection, vacuum ou prothèse pénienne.

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Correspondence to J. P. Sarramon.

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Sarramon, J.P. Etat des traitements chirurgicaux de l’impuissance. Androl. 1, 145–148 (1991). https://doi.org/10.1007/BF03034274

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Key-words

  • Vascular impotence
  • penile prostheses
  • surgery

Mots clés

  • Impuissance vasculaire
  • Revascularisation pénienne
  • Prothèses