Surgical management of erectile dysfunction

Since the introduction of sildenafil citrate, oral systemic therapy has become the first line of therapy for men with erectile dysfunction (ED). Men who are not candidates for or who fail treatment with an oral agent may choose second-line therapies such as intraurethral prostaglandins, penile injec...

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Bibliographic Details
Published in:Endocrine 2004-03, Vol.23 (2-3), p.161-165
Main Authors: Milbank, Aaron J, Montague, Drogo K
Format: Article
Language:English
Subjects:
Equipment Design
Erectile Dysfunction - surgery
Humans
Male
Penile Implantation
Penile Induration - surgery
Penile Prosthesis - adverse effects
Treatment Outcome
Vascular Surgical Procedures
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Summary:Since the introduction of sildenafil citrate, oral systemic therapy has become the first line of therapy for men with erectile dysfunction (ED). Men who are not candidates for or who fail treatment with an oral agent may choose second-line therapies such as intraurethral prostaglandins, penile injection therapy, sex therapy, or a vacuum erection device. These secondline therapies may be unpalatable or inadequate for some men, and these men constitute the candidates for surgical intervention for ED. This article reviews surgical management of vascular ED, surgical management of Peyronie's disease, and penile prosthesis implantation. At the current time, the appropriate candidate for penile revascularization is a young man with proven arterial insufficiency resulting from pelvic trauma. Results in other populations are disappointing. Peyronie's disease with curvature significant enough to interfere with intercourse may be managed with tunical lengthening or shortening procedures in potent men and with prosthetic implantation in men with ED. Modern three-piece penile prostheses are associated with excellent device reliability, high rates of patient satisfaction, and acceptably low complication rates.
ISSN:1355-008X
DOI:10.1385/ENDO:23:2-3:161