Posttraumatic impotence: angiographic evaluation

Abstract

The onset of impotence was related to penile trauma in ten of 90 patients who underwent angiography. Angiographic results facilitated diagnosis in all patients. Trauma was secondary to a variety of injuries including fractures, soft-tissue perineal injuries without fractures, and repeated perineal pounding during long, jarring drives. The final diagnosis was arteriogenic impotence (n = 2), arteriovenogenic impotence (n = 2), venogenic impotence (n = 3), venoneurogenic impotence (n = 1), neurogenic impotence (n = 1), and psychogenic impotence (n = 1). Proper angiographic evaluation required refined angiographic techniques such as selective magnification pharmacoarteriography, pharmacocavernosography, and pharmacocavernosometry. A variety of therapeutic options were either recommended or applied, depending on the angiographic findings. These included venous ligation, arterial bypass, injections of papaverine hydrochloride, and insertion of penile prostheses.