[5 years' experience with revascularization of the corpus cavernosum by a new microsurgical technic in the treatment of vascular sexual impotence].

Treatment of 138 patients with sexual impotence of vascular origin involved revascularization of the dorsal and/or cavernous arteries of the penis by means of a venous auto or homograft branched on the external iliac or femoral arteries. Arteries requiring revascularization can be clearly detected by peroperative arteriography. Two or three shunts are usually necessary. The branches of the venous graft are firstly anastomosed microsurgically (under a 25 to 30 magnification) to the dorsal and/or cavernous arteries of the penis after their microsurgical dissection. The origin of the graft is then joined to the femoral or terminal iliac arteries. Results were generally excellent and there were very few complications: thrombosis during the first 30 postoperative days in 9 cases, hemorrhage in only one case during the last 3 years, frequent but rapidly regressing edema of the foreskin, and obturation of the shunt after the first month (between the 6th and 32nd months) in 4 patients. Postoperative priapism was never noted. This technique, in contrast to that employing direct implantation of the epigastric arteries into the corpus cavernosum, ensures the return of normal physiological erections. Follow-up after a minimum of 6 months showed that recovery was total in 78.6%, the condition being made worse in only 8.8%.