Microsurgical penile revascularization for ischemic erectile dysfunction:Cumulative effective rate over time and factors affecting surgical outcomes.

Objectives: This study aimed to clarify the cumulative effectiveness of microsurgical penile revascularization over time and factors that affect surgical outcomes.

Subjects and methods: This study analyzed 114 men with a median age of 30.5 years. They had localized arterial lesions on the internal pudendal artery by angiography. They underwent the anastomosis of the distal end of the inferior epigastric artery to the dorsal artery of the penis with 11-0 sutures.

Results: The final cumulative effectiveness rate calculated by the Kaplan-Meier method was 92.5%. The 1- and 3-year cumulative effectiveness rates were 58.0% and 92.5%, respectively. Twenty-one patients were not cured during the study. Age was a factor significantly affecting the surgical outcomes (p=0.018), and the peak systolic and end-diastolic velocities on Doppler ultrasound, corporal veno-occlusive dysfunction, and venous ligation were less significant (p=0.290, p=0.559, p=0.054, and p=0.732, respectively).

Conclusion: The final cumulative effectiveness rate of penile revascularization was 92.5%. Latency was observed until cure, half of the cases were cured in approximately 10 months. Cavernous function appears to be reversible and cavernous dysfunction was not a significant factor in surgical outcome. J. Med. Invest. 71 : 219-224, August, 2024.