Skip to main content

Advertisement

Etat des traitements chirurgicaux de l’impuissance

Current status of surgical treatment for impotence

Article metrics

  • 182 Accesses

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.

References

  1. 1

    -Austoni E., Cazzaniga A., Colombo F., Toia G., Pisani F. Long term follow-up after double epigastrico-dorsal end to end anastomosis, orthoflow and antiflow. Int. J. Impotence Res., 1990, suppt 2: 440–441.

  2. 2

    -Bove D.A., Soltanik E.M., Farell G.R., Crespo E.L. Combinated penile vascular impotence. Int. J. Impotence Res. 1990, suppt 2: 394.

  3. 3

    -Crespo E.L., Soltanik E.M., Bove D.A., Farell G.R. 13 years of experience in microvascular surgery for pure arterial impotence. Int. J. Impotence Res., 1990, suppt 2: 395.

  4. 4

    -Finney R.P. Finney flexirod prosthesis. Urology, 1984, 23: 79.

  5. 5

    -Furlow W.L., Knoll L.D., Motlex R.C. Clinical experience implanting an implantable penile prosthesis with a controlled expansion cylindra. Proceedings of the third biennal world meeting on impotence, Boston, 1988: 216.

  6. 6

    -Goldstein I. Contemporary management of impotence and infertility. William Wilkin eds Baltimore, 1988: p. 171.

  7. 7

    -Hauri D.A. A new operative technique in vasculogenic erectile impotence. World J. Urol., 1986, 4: 237.

  8. 8

    -Jonas U. Five years experience with the silicone silver penile prosthesis improvements and new developments. World J. Urol., 1983, 1: 251.

  9. 9

    -Juskiewenski S., Vaysse Ph., Moscovici J., Mamoundi S., Bouissou P. A study of the arterial blood supply to the penis. Anat. Chir., 1982, 4: 101–107.

  10. 10

    -Knoll L.D., Furlow W.L., Benson R.C. Deep dorsal vein arterialization in the management of cavernosal venous leakage. Proceedings of the 86 th annual meeting of the American Urological Association, J. Urol., 1991, 145: 526.

  11. 11

    -Konnak J.W., Ohl D.A. Microsurgical penile revascularization using the central corporeal penile artery. J. Urol., 1989, 142: 305.

  12. 12

    -Lewis R.W. Venous ligation surgery for venous leakage. Int. J. Impot. Res., 1990, 2: 1–19.

  13. 13

    -Lowsley O. Impotence in man. South Med J., 1953, 12: 1091.

  14. 14

    -Mc Laren R.H., Lewis R.W. The reoperated penile implant. Int. J. Impotence Res., 1990, suppt 2: 463–464.

  15. 15

    -Merill D.C. Clinical experience with Mentor inflatable prosthesis in 206 patients. Urology, 1986, 27: 1985.

  16. 16

    -Michal V., Kramer R., Hejhal L., Direct arterial anastomosis on corporeal cavernosa penis in the therapy of erectile impotence. Rozal Chir., 1973, 52: 287.

  17. 17

    -Rossi D., Coulange C., Sermem G., Hermanowicz M., Chiapello A., Ducassou J. Resultats de traitement chirurgical de l’impuissance par fuite veineuse par mise en place du garrot veineux prothétique. Ann. Urol., 1990, 24: 306.

  18. 18

    -SARRAMON J.P., BOCCALON H., ROSSIGNOL G. Penile revascularization in Urology, L.V. Wagenchnecht ed, Thieme, 1985.

  19. 19

    -Sarramon J.P., Rischmann P., Lemba P., Bournel P., Pujol P. Microsurgery reconstruction for pure vascular impotence. J. Urol. 1990, 143: 303 A.

  20. 20

    -Small M.P., Carrion H., Gordon J.A. Small Carrion prosthesis. New implant for management of impotence. Urol., 1975, 5: 479.

  21. 21

    -Subrini L. Subrini penile implants: surgical, sexual and physiological results. Eur. Urol., 1982, 8: 22.

  22. 22

    -Virag R. Revascularization penis. In: Management of male impotence, Bennet A.M. ed., Williams Wilkins, Baltimore, 1982.

  23. 23

    -Wespes E., Corbusier A., Delcour C., Vandenbosch G., Struyven J., Schulman C.C. Deep dorsal vein arterialization in vascular impotence. Brit. J. Urol., 1989, 64: 534–538.

  24. 24

    -Wooten J.S. Ligation of the dorsal vein of the penis as a cure for atonic impotence. Texas Med J., 1902, 18: 325–328.

Download references

Author information

Correspondence to J. P. Sarramon.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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

Download citation

Key-words

  • Vascular impotence
  • penile prostheses
  • surgery

Mots clés

  • Impuissance vasculaire
  • Revascularisation pénienne
  • Prothèses