Purpose: We report our 4–year experience with deep dorsal vein arterialization at 3 years’ follow–up in young patients with pure cavernoocclusive dysfunction as an alternative to penile prosthesis implantation. Materials and Methods: We performed a modified Furlow–Fisher operation (circumflex collaterals are preserved and the deep dorsal venous valves are not disrupted by a stipper) in 25 patients who did not have risk factors such as general arteriosclerosis, coronary heart disease, hypertension, hyperlipidemia and age (over 40 years). Patients with arterial disease diagnosed by Doppler examination were excluded from the study. Also, patients with abnormal penile biothesiometric and electromyographic findings were not included in the study. Beside the subjective and objective evaluation the efficacy of the operation was also assessed retrospectively in 18 patients by telephone according to items 3 (ability to achieve an erection) and 4 (ability to maintain an erection) of the 15–item International Index of Erectile Function (IIEF). Results: With a mean follow–up of 28 months (range 4–42) subjective and objective success rates were 80 and 72% at 1 year’s 75 and 62.5% at 2 years’, and 70 and 60% at 3 years’ follow–up. According to items 3 and 4 of the 15 item IIEF questionnaire the mean postoperative scores reached 1.55–3.44 and 1.33–3.27 for items 3 and 4, respectively (p<0.01). Two patients (8%) showed signs of glans hypervascularization as a major complication and minor complications such as penile skin edema, subdermal hematoma, loss of penile skin sensation and early thrombosis of the anastomosis were found in a total of 8 patients (32%). Conclusions: Deep dorsal vein arterialization is a preferable choice in highly selected young patients as an alternative to penile prosthesis.

Michal V, Kramer R, Pospichal J, Hejhal L: Arterial epigastrico–cavernoanastomosis for the treatment of sexual impotence. World J Surg 1977;1:515–517.
Shaw WW, Zorgniotti AV: Surgical techniques in penile revascularization. Urology 1984;23: 76–78.
Levine FJ, Goldstein I: Vascular reconstruction surgery in the management of erectile dysfunction. Int J Impot Res 1990;2:59–78.
Virag F, Zwang G, Dermange H, Legman M: Vasculogenic impotence: A review of 92 cases with 54 surgical operations. Vasc Surg 1981; 15:9–17.
Furlow WL, Fisher J: Deep dorsal vein arterialization. Clinical experience with a new technique for penile revascularization (abstract 543). J Urol 1988;139:289.
Wespes E: Long–term follow–up of patients operated on for venous leakage (abstract); in Proceedings of the 6th Biennal International Symposium for Corpus cavernosum Revascularization. Boston, CME Boston University, 1998, p 193.
Lewis RW, Pryan FA, Bell DP: Another surgical approach for vasculogenic impotence. J Urol 1986;136:1210–1212.
Kayıgil Ö, Atahan Ö, Metin A: Electrical activity of the corpus cavernosum in patients with corporal veno–occlusive dysfunction. Br J Urol 1996;77:261–265.
Kayıgil Ö, Ergen A: Cavernooclusive and autonomic dysfunction: A new concept in young patients. Eur Urol 1998;34:124–127.
Kayıgil Ö, Atahan Ö, Metin A: Electromyographic changes of corpus cavernosum due to papaverine and nitroprusside in veno–occlusive dysfunction. J Urol 1996;156:1316–1319.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A: The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology 1997;49:822–830.
Kayıgil Ö, Atahan Ö, Metin A: Late glans hypervascularization subsequent to penile prosthesis implantation after revascularization operation. J Urol 1997;158:541.
Virag R, Bennett AH: Arterial and venous surgery for vasculogenic impotence: A combined French and American experience. Arch Ital Urol Nefrol Androl 1991;63:95–100.
Balko A, Malhotra CM, Wincze JP, Susset JG, Bansal S, Carrey WI, Hopkins RW: Deep penile–vein arterialization for arterial and venous impotence. Arch Surg 1986;121:774–777.
Sarramon JP, Janssen TH, Rishmann P, Bennis S, Malavod B: Deep dorsal vein arterialization in vascular impotence. Eur Urol 1994;25:29–33.
Manning M, Junemann KP, Scheepe JR, Braun P, Krautschick A, Alken P: Long–term follow–up end selection criteria for penile revascularization in erectile failure. J Urol 1998;160: 1680–1684.
Sattar AA, Merckx LA, Wespes E: Penile electromyography and its smooth muscle content: Interpretation of 25 impotent patients. J Urol 1996;156:909–912.
Stief CG, Djamillian M, Truss MC, Jan H, Than W, Jonas U: Prognostic factors for the postoperative outcome of penile venous surgery for venogenic erectile dysfunction. J Urol 1994;151:880–883.
Daley JT, Brown ML, Farber H, Saenz de Tejada I: Prostaglandin production during hypoxia in rabbit corpus cavernosum (abstract 288). J Urol 1993;149:285A.
Nehra A, Goldstein I, Pabby A, Nugent M, Huang Yue–Hua, De las Morenas A, Krane RJ, Voelson D, Saenz de Tejada I, Moreland RB: Mechanisms of venous leakage. A prospective clinicopathological correlation of corporeal function and structure. J Urol 1996;156:1320– 1329.
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