Minimally invasive procedures for vascular erectile dysfunction

Intracavernosal Injections involve the direct injection of vasodilator medications into the penis. These medications help to relax the smooth muscle within the penile arteries, promoting increased blood flow and facilitating an erection.

For men with vascular ED, intracavernosal injections can provide a quick and effective way to achieve erections, especially in cases where oral medications are ineffective. However, these are often not preferred by patients as they have to inject themselves, and do not feel spontaneous.

Arterial revascularization angioplasty is a minimally invasive procedure aimed at improving blood flow to the penis in men with specific blockages in the inflow arteries to the pelvis and penis – usually the internal iliac and internal pudendal arteries. It is typically reserved for men who have proven blockages usually from cholesterol deposits in the arteries that supply blood to the penis causing ED.

Arterial revascularization with a targeted balloon angioplasty opens up blood flow in the blocked or narrowed arteries, restoring blood flow to the penis and facilitating natural erections.

Venous Leak Surgery addresses erectile dysfunction caused by venous leak, a condition where the veins of the penis fail to adequately restrict blood flow out of the penis during an erection. This is usually seen in younger men in their 30s or 40s.

In the past, this surgery involved tying off the leaking veins to prevent the premature loss of the erection. It was a relatively major procedure that was considered when conservative treatments had failed and if a clear venous leak has been identified through diagnostic testing. The procedure had a high failure rate of over 50% within 6 months of the procedure.

The minimally invasive Glue ablation for venogenic impotence (GAVI) procedure is a much smaller procedure that takes 30 minutes or so under a short general anaesthetic. It involves injecting medical glue under direct vision and x-ray guidance into the leaking vein at the base of the penis to slow down the venous leakage. The procedure has higher success rates and minimal downtime, and is a day surgery procedure.