Surgical treatment and prevention of vasculopathic impotence in conjunction with revascularisation of the lower extremities in Leriche's syndrome.

The results are presented of combined revascularization of the lower extremities and the penis in 29 patients with Leriche's syndrome. This was effected by placing an autogenous venous shunt between the branch of a prosthesis or the common femoral artery and one of the dorsal arteries of the penis. Preoperatively lost sexual function was restored in 6 patients, while in 16 the sexual function was maintained at the preoperative level or improved in the late postoperative period.

[A new method of surgical treatment of vasculogenic impotence].

The authors describe a method of surgical management of vasculogenic impotence consisting in the formation of an anastomosis of an autovenous shunt with the dorsal artery of the penis. To prevent revascularization of the cavernous bodies of the penis with the restoration of erection, the dorsal artery of the penis is divided transversely at the root of the penis, the distal end of the autovenous shunt is given the shape of a trapezium with the upper side sutured, after which the autovenous shunt is anastomosed end to end with both the distal and proximal segments of the dorsal artery of the penis at the lateral sides of the trapezium where the angles were not sutured. The method allows incompetence and thrombosis of the vascular anastomosis to be prevented, raises the efficacy of revascularization of the cavernous bodies of the penis by creating favourable hemodynamic conditions through separation of the blood flow into the distal and proximal segments of the dorsal artery of the penis, which provides retrograde supply of blood into the deep artery of the penis sufficient for adequate revascularization of the cavernous bodies.

[Diagnosis and microsurgical correction of impotence of vascular origin].

The authors worked out an original complex of instrumental methods for the diagnosis of impotence of vascular origin, which includes ultrasonic Dopplerography of the genital arteries, radionuclide examination of hemodynamics of the penis, and radiocontrast phalloarteriography with the use of intracavernous pharmacological load. The results of the study make it possible to increase essentially the efficacy of microsurgical correction of impotence of vascular origin through objective indications for operative treatment on the basis of the suggested diagnostic methods, improvement of the techniques of revascularization of the cavernous bodies, and pathogenetically substantiated tactics of postoperative rehabilitation of patients.

[Surgical treatment and prevention of angiogenic impotence in combination with revascularization of the lower extremities in Leriche's syndrome].

The article deals with the results of combined revascularization of the lower limbs and penis in 29 patients with Leriche's syndrome. It was accomplished by creating an autovenous shunt between the blades of the prosthesis or common femoral artery with the dorsal artery of the penis. In the late-term postoperative period the initially lost sexual function was restored in 6 patients and improved or maintained on the preoperative level in 16 patients.

Predicting postoperative arterial pressure in renovascular hypertensive patients.

The authors have developed a method for forecasting the degree of the hypotensive effect of surgery for renovascular hypertension. Fifteen digital parameters were determined in 36 patients with unilateral lesions of the renal arteries by the following methods of preoperative examination: the establishment of the duration of hypertension, radio-isotope renography, determination of renin activity in the peripheral and renovascular (venous) blood, rheonephrography. The obtained set of characteristics was used for the prediction of postoperative arterial pressure values by means of one of the methods of mathematical statistics, the regression analysis in an "SM-4" electronic computer according to a specially created multivariate regression program in the "Fortran-4" language.