Erectile Dysfunction: Surgical Treatment (Vascular and Prosthetic Surgery)

Surgical treatment oferectile dysfunction (ED) can be considered in men who either fail or elect to avoid further nonoperative modalities. For patients with an organic etiology of ED, a penile prosthesis can be placed. There are multiple approaches available for penile prosthesis implantation including penoscrotal, infrapubic, and subcoronal. Furthermore, the location of reservoir placement should be considered, either within the space of Retzius or at an ectopic submuscular location according to patient factors. Potential intraoperative and postoperative complications of penile prosthesis implantation are also reviewed. Alternatively, for young and otherwise healthy men with ED secondary to focal arterial insufficiency often in the setting of pelvic trauma, penile microarterial bypass surgery is an effective treatment option. This review contains 6 figures, 2 tables, and 48 references. Key words:erectile dysfunction, inflatable penile prosthesis, malleable penile prosthesis, surgical technique, intraoperative complications, postoperative complications, arterial revascularization