Penile arteriography in vasculogenic impotence

Bifurcation aortography and selective internal pudendal arteriography were performed in 70 impotent men underthe impression of vasculogenic impotence. Age range was 6 to 63 years old(average 32). 54 patients had the historyof pelvic trauma, The studies were performed under local anethesia and simultaneous intracavernosal andintraarterial Papaverine injection before filming. To reduce pain and arterial spasm, intraarterial Lidocaine andlow osmolarity non-ionic constrast media were used. Arterial lesions were found in 50(93%) traumatic patients and7(44%) non-traumatic patients. Internal iliac arterial lesion that causing pelvic steal syndrome was noted in 3traumatic patients. Among trauma related cases there were bilateral arterial lesion in 19 patients and one axislesion in 31 patients respectively. Among 16 non-traumatic patients there were bilateral arterial lesions in 2 patients and unilateral lesion in 5 patients. Irrespective of bilaterality or unilaterality of the lesion,majority of arterial lesions were found at the distal internal pudendal artery or common penile artery level intraumatic patients. On the contrary, penile branch lesion was predominant site in non-traumatic patients. With theimproved arteriographic technique, selective penile arteriography appears acurate method in the diagnosis ofarterial impotence.