Intraoperative arteriography facilitates penile revascularization.

Penile revascularization via inferior epigastric dorsal penile artery bypass is a treatment option for men with vasculogenic impotence due to proximal segmental arterial occlusion. Various diagnostic tests have been used to identify arterial vascular disease but pudendal arteriography remains the gold standard anatomical study. Unfortunately, more than 80% of impotent men have significant variations in penile arterial anatomy, and proximal arterial occlusions may prevent adequate visualization of the intrapenile arteries. We have found that intraoperative penile arteriography performed through the dorsal penile artery facilitates the planning of the arterial anastomosis to ensure adequate blood flow to the corpora cavernosum. The indications and technique of intraoperative penile arteriography are described.