Vascular surgery (re-vascularization) is not a suitable treatment for Erectile Dysfunction

06.01.2019

Who is going to receive this treatment has to be aware about the poor long term results and that the guidelines consider it as experimental, due to the lack of consistent data and standardised procedures.

Vascular surgery (re-vascularization) for ED became widespread at the end of the 1980s, but the poor long term results have somehow compromised the initial enthusiasm. The European Association of Urology guidelines do not mention any re-vascurarization procedure in the treatment of cavernosa insufficiency. However, the American Urological Association Guidelines still considers this type of intervention as experimental, due to the lack of consistent data and standardized procedures [1]. The main procedures used today are penile re-vascularization and penile venous surgery, recommended only for selected patients and offering fair long- term results (very few cases).

In my opinion, that's supported by American and European Guidelines, these patients have to receive penile implants that are an attractive solution for patients who do not respond to more conservative therapies cases. In conclusion, there is sufficient evidence to recommend this approach in all Erectile Dysfunction patients not responding to less-invasive treatments due to its high efficacy, safety and satisfaction rates.

[1] Munarriz R, Mulhall J, Goldstein I. Glenn's Urologic Surgery. Philadelphia: Lippincott Williams and Wilkins; 2004. Penile arterial reconstruction; pp. 573-587.