Arterial anatomy and arteriographic diagnosis of arteriogenic impotence

One hundred twenty-six bilateral selective arteriographic
examinations of the iliopudendal vascular tree were performed after
comprehensive multidisciplinary evaluation in patients with chronic
erectile dysfunction. Best imaging results were obtained by
performing the arteriography under epidural anesthesia after
intracavernous injection of a vasoactive drug combination. The
arteriography is mandatory prior to revascularization procedures.
It is further indicated in primary erectile dysfunction and
posttraumatic erectile failure. The importance of cavernosography
and selective arteriography in primary erectile dysfunction is
stressed. Increasing knowledge about the influence of vasoactive
drugs on penile hemodynamics has led to its application in
diagnosis and therapy of erectile dysfunction.
Pharmacocovernosography, Doppler-ultrasound of penile arteries
after intracavernous injection of a vasoactive drug combination,
and pharmacoarteriography are refined techniques to prove a
vascular etiology of erectile dysfunction. The results of the
morphologic studies of the vascular system are correlated with
functional testing of erectile capacity by intracavernous
application of a papaverinephentolamine drug combination.