Penile Microvascular Arterial Bypass Surgery: Indications, Outcomes, and Complications

摘要: Penile microarterial bypass surgery (MABS) may be the only treatment capable of restoring normal erectile function without necessity for chronic use vasoactive medications or placement a penile prosthesis. Lack standardization in patient selection, hemodynamic evaluation, surgical technique, and limited long-term outcome data using validated instruments has resulted this being considered experimental. The members Erectile Dysfunction Guideline Update Panel reviewed available MABS publications four 31 manuscripts met criteria Arterial Occlusive Disease Index patient. total studied population these was 50, which too small to determine if is effective not. Reported successful outcomes were 36-80 91% inferior epigastric artery (IEA) dorsal vein IEA MABS, respectively. We recently published largest study questionnaires (71 men aged 30.5 +/- 9.2 years; mean follow-up 34.5 18 months). pre- postoperative International Function, domain, questions 3 4 scores 35.5 14.8, 13.7 6.7, 2.2 1.4, 2.1 1.3, 56.2 16.6, 23.8 6.6, 4.1 3.9 1.5, In addition, 55 73% patients reported domain > =26 21, respectively, almost 90% would recommend undergo again. changes sexual distress scale Center Epidemiologic Studies Depression Scale statistically significant. More importantly, satisfaction (EDITS) very high, 87% someone else 88.7% significant improvement their function. with no vascular risk factors pure cavernosal arterial insufficiency, provides improvements function, depression, overall satisfaction.