Editorial Comment: Penile revascularization utilizing the lateral femoral circumflex artery after pelvic fracture urethral injury

Favorito, Luciano A.

doi:10.1590/S1677-5538.IBJU.2023.05.02

Koch G ¹ 1 Vanderbilt University Medical Center , Gleicher S ¹ 1 Vanderbilt University Medical Center , Criman E ¹ 1 Vanderbilt University Medical Center , Sandvall B ¹ 1 Vanderbilt University Medical Center , Johnsen N ¹ 1 Vanderbilt University Medical Center

J Sex Med. 2023; 20:(suppl1), qdad060.412.

DOI: 10.1093/jsxmed/qdad060.412 | ACCESS: qdad060.412

COMMENT

The present paper shows how the anatomy is important to urology. The authors demonstrate the use of an alternative arterial donor vessel for penile revascularization.

Using an operating microscope the dorsal penile artery was ligated and the distal end was anastomosed to the donor artery and an end-to-end fashion with the lateral femoral circumflex artery. Penile vascular anatomy is basic for this procedure. The penis is irrigated by two internal pudendal arteries, branches of the internal iliac (hypogastric) artery. After its various perineal branches, the pudendal arteries combine to form the so-called common penile artery, which divides into three branches: the bulbourethral artery, the dorsal penile artery and the cavernosal artery. The cavernosal artery is located inside the corpus cavernosum, the bulbourethral artery is responsible for irrigating the corpus spongiosum and urethra, and the dorsal penile artery is located between the tunica albuginea and Buck’s fascia (¹1 Vora AA, Dajani D, Lynch JH, Kowalczyk KJ. Anatomic and technical considerations for optimizing recovery of urinary function during robotic-assisted radical prostatectomy. Curr Opin Urol. 2013;23:78-87., ²2 Walz J, Burnett AL, Costello AJ, Eastham JA, Graefen M, Guillonneau B, et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol. 2010;57:179-92.).

The authors concluded that this case demonstrates an excellent result from penile revascularization utilizing the lateral femoral circumflex artery. This artery can be considered an alternate donor for penile revascularization procedures following pelvic fracture urethral injury when there is a contraindication to the use of the inferior epigastric artery.

REFERENCES

¹
Vora AA, Dajani D, Lynch JH, Kowalczyk KJ. Anatomic and technical considerations for optimizing recovery of urinary function during robotic-assisted radical prostatectomy. Curr Opin Urol. 2013;23:78-87.
²
Walz J, Burnett AL, Costello AJ, Eastham JA, Graefen M, Guillonneau B, et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol. 2010;57:179-92.

Publication Dates

Publication in this collection
01 Sept 2023
Date of issue
Sep-Oct 2023

History

Received
05 May 2023
Accepted
10 May 2023
Published
25 June 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

[1] ¹
Vora AA, Dajani D, Lynch JH, Kowalczyk KJ. Anatomic and technical considerations for optimizing recovery of urinary function during robotic-assisted radical prostatectomy. Curr Opin Urol. 2013;23:78-87.

[2] ²
Walz J, Burnett AL, Costello AJ, Eastham JA, Graefen M, Guillonneau B, et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol. 2010;57:179-92.

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