Penile revascularization - modern approach

The article is devoted to the description and analysis of the penile revascularization technique with concurrent use of small doses of the inhibitors of phosphodiesterase type 5 (PDE-5) in the early postoperative period. All patients were analyzed in the age group 18-50 years, which were treated due to the diagnosis of vasculogenic erectile dysfunction in the Federal Medical Center named after Burnasyan A.I. (FMBA, Russia) using the Virag-Kovalev technique with standard postoperative care and also with addition of tadalafil 5 mg for penile rehabilitation. Clinical data was gathered and assessed with accent at the early and late outcomes and complications. Median followup period was 1 year after the surgical treatment. Study group patients received small doses of the PDE-5 inhibitors starting from the day 2 after operation. In both groups the improvement of the erectile function was observed with the ability to perform full sexual intercourse and the presence of the spontaneous erections without any peroral or cavernous therapy. Nevertheless in the study group the frequency of recurrences at 1 year after operation was lower than in the control group. According to the results we conclude, that given the proper selection of the patients and adequate postoperative care, microsurgical revascularization of the penis using the Virag-Kovalev technique could be an effective method of treatment in patients with vasculogenic erectile dysfunction. Utilization of the PDE-5 inhibitors in small doses early after operation contributes to the significant improvement of the early and late outcomes of the treatment and quality of the life.