Vasculogenous impotence

Impotence - the inability to have an erection (erectile dysfunction), can be psychogenic or organic.

Insufficient arterial inflow

 * Central - arterial occlusion in the aortoiliac region.
 * Peripheral - arterial occlusion of the branches of the pelvic arteries or directly the arteries of the penis.
 * Other - arterial injuries in fractures of the pelvic bones, dysplasia of the deep arteries of the penis.

Therapy

 * Reconstructive procedures on pelvic arteries (endarterectomies, bypasses).
 * Or reconstructive procedures on penile arteries (epigastric-penile bypass).
 * If they fail, implantation of penile endoprosthesis.

Phlebogenous impotence

 * Increased venous outflow (insufficient blockage).
 * Treatment by ligation or embolization of veins (v. dorsalis penis, v. penis profunda).
 * Conservative treatment with vasoactive agents (relaxation of the smooth muscle of the feeding arteries) - prostaglandins, papaverine, sildenafil (Viagra®) = phosphodiesterase inhibitor.

Related articles

 * Penis, Penis – structure (draw cross-section), vascular and nerve supply, mechanism of errection
 * Vascular prosthetic devices
 * Vascular substitutes