Penile Vascular Surgery

Isolated stenosis or occlusion of the extrapenile arteries is amenable to surgical repair. Restoration of potency has been reported after surgery of the internal iliac and internal pudendal arteries. Currently, the most commonly used technique for penile revascularization is a bypass from the inferior epigastric artery to the dorsal artery or deep dorsal vein of the penis. This procedure is indicated only in young men with congenital or traumatic arterial insufficiency (_{Hakim et al, 1995}). 

Nonsurgical Treatment of Erectile Dysfunction

Although the penile prosthesis remains one of the most effective treatments for all types of ED, nonsurgical management has replaced prosthetic surgery as the preferred choice in the last decade. Both specific and nonspecific treatments are available. The former include psychotherapy, change of offending medications, and hormonal therapy; the latter include sildenafil, vacuum constriction device, transurethral therapy and intracavernous injection. Although nonspecific therapies appear to be more effective for most cases of ED, the patient should also be made aware of specific therapies.