ABSTRACT

Since the introduction of PDE5, oral systemic therapy has become the first line of therapy for men with erectile dysfunction (ED). Men who are not candidates for, or who fail treatment with an oral agent may choose second-line therapies such as intraurethral prostaglandins, penile injection therapy, sex therapy, or a vacuum erection device. These second-line therapies may be unpalatable or inadequate for some men, and these constitute the candidates for surgical intervention for ED. This article reviews the surgical management of vascular ED, and surgical management of penile prosthesis implantation. Currently, the appropriate candidate for penile revascularization is a young man with proven arterial insufficiency resulting from pelvic trauma. (JAREM 2011; 1: 61-4)