Pelvic hemodynamics before and after aortoiliac vascular reconstruction: the significance of penile blood pressure

The relationship between penile pressure and hypogastric arterial insufficiency, as well as the changes in the penile brachial pressure index and male sexual function after aortoiliac vascular reconstruction, were investigated in 47 patients with arteriosclerosis obliterans and in 6 patients with Buerger's disease. When the penile brachial pressure index was greater than 0.7, a value compatible with normal sexual function, there was enough arterial circulation to keep at least one hypogastric artery patent. In cases where there was insufficiency of both hypogastric arteries, the index increased significantly after the inflow was restored, even if it was unilateral, following arterial reconstruction. Reconstruction of the blood flow to the femoral artery tended to increase the index even without restoration of hypogastric flow, especially when the inferior mesenteric artery was occluded. In cases of high aortic occlusion, restoration of blood to the femoral artery alone led to a greatly significant increase in the index. These facts indicate that branches of the femoral artery and the inferior mesenteric artery play an important role in the collateral circulation of pelvic hemodynamics when the hypogastric artery is occluded.