33 patients underwent a penile deep dorsal vein arterialization (DDVA) (11 venous leak, 8 pure arteriogenic impotence, 14 mixed arterial and venous impotence). The mean follow-up was 12 months. Surgery was considered successful when the patients had permeable anastomosis and were able to achieve satisfactory erections resulting in normal intercourse. 92% of the patients with venous leak, 62.5% of those with arteriogenic impotence and 58% with mixed lesions had a successful results. Due to antithrombotic therapy, there was no graft occlusion. Gians hypervascularity occurred in 3 patients and was treated by arterial banding. The role of DDVA in vascular impotence and its functional mechanism are discussed.

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