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Objective: |In penile revascularization surgery, it is ideal for there to be no turbulence flow at the anastomotic site to achieve long-term patency. For this reason, end-to-side anastomosis was once the method of choice, but was then superseded the end-to-end anastomosis method. The harvested inferior epigastric artery was anastomosed to either the proximal or peripheral end of the transected dorsal artery of the penis, and the other was ligated. However, since bilateral revascularization is more physiological, we attempted bidirectional revascularization using the rectus muscle branch of the inferior epigastric artery (λ-shaped anastomosis). Subjects and methods: Subjects were 20 consecutive young traumatic arterial erectile dysfunction patients diagnosed according to the ISSM SOP. The distal end of the inferior epigastric artery were dissected about 10 cm, and the main trunk and abdominal muscle branch were transferred to the base of the penis. Both proximal and peripheral directions of the transected dorsal artery of the penis were anastomosed. Results: This procedure was able to be performed in 7 cases. During the follow-up period (median: 28 months), patency of the anastomotic site was confirmed by ultrasound in all cases. In the other 13 cases, λ-shaped anastomosis was abandoned mainly due to the diameter and length of the rectus muscle branch. No complications of IIIa or higher were observed. Conclusion: The λ-shaped anastomosis could only be performed in 35% of the cases as a result of the rectus abdominis muscle branch being too thin. When surgical skill with this anastomosis type is improved, it will be applied to 70% of cases. We would like to continue this surgery and follow long-term patency rates. [ABSTRACT FROM AUTHOR]

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Copyright of Japanese Journal of Sexual Medicine is the property of Japanese Society for Sexual Medicine (JSSM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)