Eduardo B Bertero1, Dimas L Antunes2. 1. Department of UrologySection of Sexual MedicineHospital do Servidor Publico EstadualSão PauloSPBrazil. Electronic address: urologia-sp@uol.com.br. 2. Department of UrologySection of Sexual MedicineHospital do Servidor Publico EstadualSão PauloSPBrazil.
Abstract
INTRODUCTION: Currently, oral pharmacotherapy is the dominant treatment for erectile dysfunction. AIM: The aim of this article is to give an up-to-date summary of the possibilities of surgical therapy. METHODS: A search of the literature over the last decade was performed. Relevant papers and guidelines on the topic were reviewed and included. MAIN OUTCOME MEASURE: We evaluate therapy options, such as penile vein surgery, arterial revascularization, and penile prosthetics. RESULTS: Vein surgery has faded into total insignificance due to the efficiency of oral and intracavernous therapeutics, and because of the known pathophysiology of corporal veno-occlusive dysfunction and the disappointing long-term results published in the literature. Penile revascularization surgery is performed today only in very limited number of patients with strict selection criteria such as age and exclusion of vascular risk factors. CONCLUSIONS: Penile prosthetics is the only surgical therapy option maintaining its significance as a cure for erectile dysfunction. There are convincing long-term results with a high degree of patient and partner satisfaction, high patient acceptance, and a good functional durability of the mostly three-piece inflatable devices. Bertero EB and Antunes DL. Surgical treatment of erectile dysfunction.
INTRODUCTION: Currently, oral pharmacotherapy is the dominant treatment for erectile dysfunction. AIM: The aim of this article is to give an up-to-date summary of the possibilities of surgical therapy. METHODS: A search of the literature over the last decade was performed. Relevant papers and guidelines on the topic were reviewed and included. MAIN OUTCOME MEASURE: We evaluate therapy options, such as penile vein surgery, arterial revascularization, and penile prosthetics. RESULTS: Vein surgery has faded into total insignificance due to the efficiency of oral and intracavernous therapeutics, and because of the known pathophysiology of corporal veno-occlusive dysfunction and the disappointing long-term results published in the literature. Penile revascularization surgery is performed today only in very limited number of patients with strict selection criteria such as age and exclusion of vascular risk factors. CONCLUSIONS: Penile prosthetics is the only surgical therapy option maintaining its significance as a cure for erectile dysfunction. There are convincing long-term results with a high degree of patient and partner satisfaction, high patient acceptance, and a good functional durability of the mostly three-piece inflatable devices. Bertero EB and Antunes DL. Surgical treatment of erectile dysfunction.