September 2019
Modern approaches to erectile dysfunction (ED) often involve multimodal medical therapy and surgery.
Why this matters
Modern approaches to erectile dysfunction (ED) often involve multimodal medical therapy and surgery. This work contributes to evidence-based plastic and reconstructive surgery — helping clinicians interpret outcomes, refine technique, and counsel patients with clearer data.
Author
Plastic and reconstructive surgery resident at Emory University (UCLA BS, USC MD) with an h-index of 21 and peer-reviewed work spanning aesthetic surgery, reconstruction, medical devices, and AI in medicine.
Abstract
Modern approaches to erectile dysfunction (ED) often involve multimodal medical therapy and surgery. Recent advances in microsurgery have introduced new options for patients suffering from ED. This review reevaluates anatomical and physiological principles that mediate erection, aiming to enhance the understanding for reconstructive surgeons exploring new interventions. Various approaches are available to restore nerve function and treat neurogenic and vasculogenic ED. Somatic sensory loss can be addressed through direct neurorrhaphy or neuroplasty, while microvascular techniques can repair damaged small vessels in the pelvis. Classical approaches include vein stripping to reduce venous outflow or direct vascularization to improve inflow. Microsurgical interventions have shown improvements in ED following radical prostatectomy. Continued innovation and collaboration between plastic surgeons and urologists will provide solutions to this common and challenging issue.