1/3. Glans hyperemia after penile revascularization: a late complication following alpha-1-receptor blockade for benign prostatic hyperplasia.Surgical revascularization of the penile vessels is one treatment choice for patients with vasculogenic impotence. hyperemia of the glans is a rare but severe complication which usually occurs early. We report a patient who developed this complication more than 3.5 years after surgery following onset of medical treatment of benign prostatic hyperplasia with a vasodilating alpha 1-receptor blocker.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/3. Laparoscopically assisted penile revascularization for vasculogenic impotence: 2 additional cases.PURPOSE: Microsurgical revascularization of the penis in vasculogenic impotence is an accepted surgical procedure in young men with a history of blunt pelvic or perineal trauma. Most penile revascularization techniques use the inferior epigastric artery in direct artery-to-artery revascularization or dorsal vein arterialization procedures. To obviate the wide pararectal incision laparoscopic mobilization of the inferior epigastric vessels has been recently proposed. We present 2 cases of successful laparoscopically assisted penile revascularization. MATERIALS AND methods: With the patient under general anesthesia the first trocar was inserted in the umbilical region and pneumoperitoneum was induced. Two other trocars were positioned laterally. As soon as the inferior epigastric vessels were accessed, dissection was initiated below the level of the arcuate line. The vessels were dissected cephalad en bloc to a point of bifurcation of the inferior epigastric artery above the umbilical level. The inferior epigastric pedicle was ligated with clips and transected at the cephalad edge of the dissection. It was then mobilized and tunneled through an infrapubic incision at the base of the penis for subsequent microvascular anastomosis with the penile vessels. RESULTS: The anastomosis was patent and hemostasis was satisfactory. operative time in the 2 cases was 4.3 and 5.2 hours, respectively. At 3 months both patients reported complete erections. CONCLUSIONS: Our experience confirms the extremely practical use of laparoscopy which, due to its magnification power, makes it possible to perform fast, accurate excision of the epigastric bundle. Moreover, a wide pararectal incision, which is a frequent cause of postoperative complications, is avoided.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
3/3. erectile dysfunction due to single vessel failure: diagnosis and surgical treatment.We report on the successful surgical treatment of venous single vessel disease in a patient presenting with erectile dysfunction. We stress the necessity of accurate diagnostic workup which enables the identification of rare cases that can be cured surgically.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |