Undergoing vascular surgery for arterial disease
THE AIM OF SURGERY IS TO INCREASE
ARTERIAL BLOOD FLOW TO THE PENIS.
This result can be obtained by two types of surgery:
– Percutaneous angioplasty and stenting of obstructed arteries
– Bypass connecting a new artery to the penis.
Choice between these two options is performed according to patient specificities.
Siemens hybrid room allowing 3D visualization of arteries.
CONDITIONS REQUIRED TO DECIDE FOR ARTERIAL SURGERY
CONDITIONS REQUIRED TO DECIDE FOR ARTERIAL SURGERY
ERECTION DYSFUNCTION FOR MORE THAN 6 MONTHS
ERECTION DYSFUNCTION FOR MORE THAN 6 MONTHS
SIGNIFICANT DECREASE IN BLOOD FLOW TO THE PENIS DUE TO ARTERIAL OBSTRUCTION
SIGNIFICANT DECREASE IN BLOOD FLOW TO THE PENIS DUE TO ARTERIAL OBSTRUCTION
MEDICATIONS FOR ERECTION MUST BE UNEFFICIENT OR POORLY EFFICIENT
MEDICATIONS FOR ERECTION MUST BE UNEFFICIENT OR POORLY EFFICIENT
THE POSSIBILITY OF A PENIS IMPLANT HAS BEEN DISCUSSED AND RULED OUT BY PATIENT
THE POSSIBILITY OF A PENIS IMPLANT HAS BEEN DISCUSSED AND RULED OUT BY PATIENT
PATIENT HAS EXPRESSED HIS WILL TO BE OPERATED ON AFTER INFORMATION
PATIENT HAS EXPRESSED HIS WILL TO BE OPERATED ON AFTER INFORMATION
Percutaneous angioplasty and stenting
of an artery providing blood to the penis (arrow: balloon for angioplasty)
Bypass to the penis (arrow)
SURGERY
For a bypass:
- General anesthesia
- Scar: in pubic airs and in lower part of the abdomen
- Ablation of prepuce is sometimes necessary, and will be discussed with the surgeon
- Duration: 3 to 6 hours
- Hospitalisation: one week
For percutaneous angioplasty and stenting:
- General anesthesia
- No scar. Puncture of the two groins
- Hospitalisation: ambulatory, or two nights.
SURGERY RISKS
– Percutaneous angioplasty and stent do not induce penis edema nor glan ulceration
– After a bypass surgery on the penis:
- Transient edema of the penis always occurs
- Pulsatile pain in the glan may require complementary surgery
- Transient ulcerations of the glan may occur
- Decrease in penis skin or glan sensitivity may occur, usually transient.
POST-OPERATIVE PERIOD
– Anticoagulation treatment and/or Aspirin is given
– Airplain travels are forbidden for at least 2 weeks
– Sexual intercourses are not recommended for 1 to 2 months after surgery
FREQUENT QUESTIONS
What is the follow-up after surgery?
A duplex-scanner and an Angio-CTA are performed before discharge to assess revascularization. We recommend a yearly control by Duplex-scanner.
Are medications for erection useful after surgery?
During the first months, erection pills can help recovering sexual activity
Is sexologist or psychologist help required?
Impotence is a trauma. Erection is a complex process that put men under stress and obligation to perform. As a complement to surgery, psychological help can be useful.
What is important after surgery?
Controlling cardiovascular risk factors (diabetes, hypertension, cholesterol blood level, smoking, overweight) is critical, as well as a global cardiovascular follow-up.
What is best life-style after surgery?
Surgery is an opportunity to reconsider way of life, particularly with regard to stress, tiredness, and addictions such as tobacco, alcohol. Sport, relaxation and balanced diet help recover harmony in life.