A normal penile erection is an intricate mechanism that involves arterial flow, smooth muscle relaxation, and corporoveno-occlusive function. Any dysfunction in these mechanisms could lead to erectile dysfunction (ED).
Although there a number of physical and psychological causes of ED, the most widely recognized pathological and vascular etiologies causing ED are arterial insufficiency, corporoveno-occlusive dysfunction, or both.
In most men, corporoveno occlusion is considered the most common cause of ED.
In vascular erectile dysfunction, it has been found that corpora cavernosa, a sponge tissue of the penile organ, shows lower oxygen tension, which leads to reduced volume of cavernosal smooth muscle and corporoveno occlusion.
Several studies have supported the argument that corporoveno-occlusive dysfunction is actually an effect rather than the real cause of ED.
So, many believe that ED can be treated effectively with surgical interventions through “penile revascularization surgery” of the blocked or clogged arteries and “penile venous surgery” for corporoveno-occlusive dysfunction.
However, the efficacy of surgical interventions has been unproven and debatable due to the lack of hemodynamic assessment and validated outcome measures.
According to current guidelines, penile vascular surgery has been disclaimed to be the treatment of choice for ED. However, there have been reports suggesting that penile revascularization surgery for arterial insufficiency could be effective in healthy patients who are under 55 years with ED caused by arterial occlusion.
In addition, it has been found that penile venous surgery could be beneficial for some selected patients who have ED due to corporoveno occlusion.
Researchers say that penile vascular surgery might remain one of the viable alternatives for treating erectile dysfunction. It may have found its niche in the possibility of getting spontaneous, unaided, and natural erection. More details on the safety and efficacy of penile vascular surgery can be found in the International Journal of Urology, an official journal of the Japanese Urological Association.
