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Endovascular Approaches to Penile Arterial Revascularization for Vasculogenic Erectile Dysfunction

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Book cover Contemporary Treatment of Erectile Dysfunction

Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Erectile dysfunction (ED) and coronary artery disease (CAD) share many common cardiovascular risk factors, including age, diabetes, hypertension, dyslipidemia, and tobacco use (Thompson et al., JAMA 294(23):2996–3002, 2005; El-Sakka et al., J Urol 172(1):251–254, 2004; Rosen et al., J Urol 145(4):759–763, 1991). ED has been shown to be a preceding symptom of CAD and a risk factor for development of cardiovascular disease (Gazzaruso et al., Circulation 110(1):22–26, 2004), with up to 70 % of males experiencing new-onset angina and angiographically confirmed CAD having a previous past medical history significant for ED (Chiurlia et al., J Am Coll Cardiol 46(8):1503–1506, 2005; Dong et al., J Am Coll Cardiol 58(13):1378–1385, 2011; Montorsi et al., Eur Urol 44(3):360–364, 2003). Prior angiographic studies have observed significant obstructive atherosclerotic disease in iliac, internal pudendal, and cavernosal arteries in males with ED (Bookstein et al., J Urol 137(2):333–337, 1987; Mueller et al., J Urol 143(5):928–932, 1990; Rosen et al., Radiology 174(3 Pt 2):1043–1048, 1990). Although the causes for ED are multifactorial, the vasculogenic etiology is the most predominant, with one study documenting that it may account for >80 % of cases of ED (Ramanathan et al., J Sex Med 4(5):1336–1344, 2007) with the arteriogenic subtype present in greater than 55 % of males with ED (Virag et al., Lancet 1(8422):181–184, 1985). Furthermore, of the 50 % of males who had suboptimal responses to PDE5i pharmacotherapy, 90 % have been shown to have angiographically severe penile arterial insufficiency (PAI) (Montorsi et al., BJU Int 91(5):446–454, 2003). Thus, there exists a potential need for the development of minimally invasive penile arterial revascularization therapies for the treatment of vasculogenic ED. This chapter will discuss the current state of endovascular penile arterial revascularization for vasculogenic erectile dysfunction. We will aim to summarize background anatomy and physiology, etiologies of ED, and the ZEN trial of pudendal artery stents. Last, we focus on endovascular stent restenosis, available imaging modalities, recent work on transluminal balloon angioplasty of the penile arterial supply, and future directions for the field of endovascular penile arterial revascularization for the treatment of vasculogenic erectile dysfunction.

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References

  1. NIH Consensus Conference. Impotence: NIH consensus development panel on impotence. JAMA. 1993;270(1):83–90.

    Article  Google Scholar 

  2. Bhatt DL, Steg PG, Ohman EM, et al. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295(2):180–9.

    Article  CAS  PubMed  Google Scholar 

  3. Ayta IA, McKinlay JB, Krane RJ, et al. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999;84(1):50–6.

    Article  CAS  PubMed  Google Scholar 

  4. Smith KJ, Roberts MS. The cost-effectiveness of sildenafil. Ann Intern Med. 2000;132(12):933–7.

    Article  CAS  PubMed  Google Scholar 

  5. Willke RJ, Yen W, Yang SC, et al. Quality of life effects of alprostadil therapy for erectile dysfunction: results of a trial in Europe and South Africa. Int J Impot Res. 1998;10(4):239–46.

    Article  CAS  PubMed  Google Scholar 

  6. Campbell HE. Clinical monograph for drug formulary review: erectile dysfunction agents. J Manag Care Pharm. 2005;11(2):151–71.

    PubMed  Google Scholar 

  7. Montague DK, Jarow JP, Broderick GA, et al. Chapter 1: the management of erectile dysfunction: an AUA update. J Urol. 2005;174(1):230–9.

    Article  PubMed  Google Scholar 

  8. Thompson IM, Tangen CM, Goodman PJ, et al. Erectile dysfunction and subsequent cardiovascular disease. JAMA. 2005;294(23):2996–3002.

    Article  CAS  PubMed  Google Scholar 

  9. El-Sakka AI, Morsy AM, Fagih BI, et al. Coronary artery risk factors in patients with erectile dysfunction. J Urol. 2004;172(1):251–4.

    Article  PubMed  Google Scholar 

  10. Rosen MP, Greenfield AJ, Walker TG, et al. Cigarette smoking: an independent risk factor for atherosclerosis in the hypogastric-cavernous arterial bed of men with arteriogenic impotence. J Urol. 1991;145(4):759–63.

    CAS  PubMed  Google Scholar 

  11. Gazzaruso C, Giordanetti S, De Amici E, et al. Relationship between erectile dysfunction and silent myocardial ischemia in apparently uncomplicated type 2 diabetic patients. Circulation. 2004;110(1):22–6.

    Article  PubMed  Google Scholar 

  12. Chiurlia E, D’Amico R, Ratti C, et al. Subclinical coronary artery atherosclerosis in patients with erectile dysfunction. J Am Coll Cardiol. 2005;46(8):1503–6.

    Article  PubMed  Google Scholar 

  13. Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol. 2011;58(13):1378–85.

    Article  PubMed  Google Scholar 

  14. Montorsi F, Briganti A, Salonia A, et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol. 2003;44(3):360–4. discussion 364–365.

    Article  PubMed  Google Scholar 

  15. Bookstein JJ, Valji K, Parsons L, et al. Pharmacoarteriography in the evaluation of impotence. J Urol. 1987;137(2):333–7.

    CAS  PubMed  Google Scholar 

  16. Mueller SC, von Wallenberg-Pachaly H, Voges GE, et al. Comparison of selective internal iliac pharmaco-angiography, penile brachial index and duplex sonography with pulsed Doppler analysis for the evaluation of vasculogenic (arteriogenic) impotence. J Urol. 1990;143(5):928–32.

    CAS  PubMed  Google Scholar 

  17. Rosen MP, Greenfield AJ, Walker TG, et al. Arteriogenic impotence: findings in 195 impotent men examined with selective internal pudendal angiography. Young Investigator’s Award. Radiology. 1990;174(3 Pt 2):1043–8.

    Article  CAS  PubMed  Google Scholar 

  18. Kloner RA, Mullin SH, Shook T, et al. Erectile dysfunction in the cardiac patient: how common and should we treat? J Urol. 2003;170(2 Pt 2):S46–50. discussion S50.

    Article  PubMed  Google Scholar 

  19. Montorsi F, Salonia A, Deho F, et al. Pharmacological management of erectile dysfunction. BJU Int. 2003;91(5):446–54.

    Article  CAS  PubMed  Google Scholar 

  20. Virag R, Bouilly P, Frydman D. Is impotence an arterial disorder? A study of arterial risk factors in 440 impotent men. Lancet. 1985;1(8422):181–4.

    Article  CAS  PubMed  Google Scholar 

  21. Philip F, Shishehbor MH. Current state of endovascular treatment for vasculogenic erectile dysfunction. Curr Cardiol Rep. 2013;15(5):360.

    Article  PubMed  Google Scholar 

  22. Rogers JH, Rocha-Singh KJ. Endovascular therapy for vasculogenic erectile dysfunction. Curr Treat Options Cardiovasc Med. 2012;14(2):193–202.

    Article  PubMed  Google Scholar 

  23. Rogers JH, Goldstein I, Kandzari DE. Zotarolimus-eluting peripheral stents for the treatment of erectile dysfunction in subjects with suboptimal response to phosphodiesterase-5 inhibitors. J Am Coll Cardiol. 2012;60(25):2618–27.

    Article  CAS  PubMed  Google Scholar 

  24. Kinsey AC, Pomeroy WR, Martin CE, et al. Sexual behavior in the human male. Am J Public Health. 2003;93(6):894–8.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Saenz de Tejada I, Goldstein I, Azadzoi K, et al. Impaired neurogenic and endothelium-mediated relaxation of penile smooth muscle from diabetic men with impotence. N Engl J Med. 1989;320(16):1025–30.

    Article  CAS  PubMed  Google Scholar 

  26. Rajfer J, Rosciszewski A, Mehringer M. Prevalence of corporeal venous leakage in impotent men. J Urol. 1988;140(1):69–71.

    CAS  PubMed  Google Scholar 

  27. Metz P, Ebbehoj J, Uhrenholdt A, et al. Peyronie’s disease and erectile failure. J Urol. 1983;130(6):1103–4.

    CAS  PubMed  Google Scholar 

  28. Dalkin BL, Carter MF. Venogenic impotence following dermal graft repair for Peyronie’s disease. J Urol. 1999;46(3):849–51.

    Google Scholar 

  29. Dean RC, Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am. 2005;32(4):379–95. v.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Greenstein A, Chen J, Miller H, et al. Does severity of ischemic coronary disease correlate with erectile function? Int J Impot Res. 1993;9(3):123–6.

    Article  Google Scholar 

  31. Montorsi P, Ravagnani PM, Galli S, et al. The artery size hypothesis: a macrovascular link between erectile dysfunction and coronary artery disease. Am J Cardiol. 2005;96(12B):19M–23.

    Article  PubMed  Google Scholar 

  32. Gandaglia G, Briganti A, Montorsi F, et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Eur Urol. 2014;65:968–78. Eur Urol 66(5): e88–89.

    Article  PubMed  Google Scholar 

  33. Azadzoi KM, Goldstein I, Siroky MB, et al. Mechanisms of ischemia-induced cavernosal smooth muscle relaxation impairment in a rabbit model of vasculogenic erectile dysfunction. J Urol. 1998;160(6 Pt 1):2216–22.

    Article  CAS  PubMed  Google Scholar 

  34. Azadzoi KM. Vasculogenic erectile dysfunction: beyond the haemodynamic changes. BJU Int. 2006;97(1):11–6.

    Article  PubMed  Google Scholar 

  35. Lue TF. Erectile dysfunction. N Engl J Med. 2000;342(24):1802–13.

    Article  CAS  PubMed  Google Scholar 

  36. Siroky MB, Azadzoi KM. Vasculogenic erectile dysfunction: newer therapeutic strategies. J Urol. 2003;170(2 Pt 2):S24–9. discussion S29–30.

    Article  PubMed  Google Scholar 

  37. Leriche R. Des obliterations arterielle hautes (oblideration de la termination de l’aorte) comme cause de insufficances circulatoire des membres inferieurs (abstr). Bull Mem Soc Chir. 1923;49:1404.

    Google Scholar 

  38. May AG, Deweese JA, Rob CG. Changes in sexual function following operation on the abdominal aorta. Surgery. 1969;65(1):41–7.

    CAS  PubMed  Google Scholar 

  39. Carstensen G. Treatment of impotentia coeundi by reconstructing the circulation in the internal iliac artery. Langenbecks Arch Chir. 1969;325:885–8.

    Article  CAS  PubMed  Google Scholar 

  40. Michal V, Kramar R, Pospichal J, et al. Direct arterial anastomosis on corpora cavernosa penis in the therapy of erective impotence. Rozhl Chir. 1973;52(9):587–90.

    CAS  PubMed  Google Scholar 

  41. Zorgniotti AW, Padula G, Rossi G. Impotence caused by pudendal arteriovenous fistula. Urology. 1979;14(2):161–2.

    Article  CAS  PubMed  Google Scholar 

  42. Ginestie J, Romieu A. The treatment of impotence of vascular origin. Revascularisation of the corpora cavernosa. J Urol Nephrol. 1976;82(10-11):853–9.

    CAS  Google Scholar 

  43. Michal V, Pospischal J. Phalloarteriography in the diagnosis of erectile impotence. World J Surg. 1978;2(2):239–48.

    Article  CAS  PubMed  Google Scholar 

  44. Valji K, Bookstein JJ. Transluminal angioplasty in the treatment of arteriogenic impotence. Cardiovasc Intervent Radiol. 1988;11(4):245–52.

    Article  CAS  PubMed  Google Scholar 

  45. Shishehbor MH, Philip F. Endovascular treatment for erectile dysfunction: an old paradigm revisited. J Am Coll Cardiol. 2012;60(25):2628–30.

    Article  PubMed  Google Scholar 

  46. Castaneda-Zuniga WR, Gomes A, Weens C, et al. Transluminal angioplasty in the management of mesenteric angina. Rofo. 1982;137(3):330–2.

    Article  CAS  PubMed  Google Scholar 

  47. Van Unnik JG, Marsman JW. Impotence due to the external iliac steal syndrome treated by percutaneous transluminal angioplasty. J Urol. 1984;131(3):544–5.

    PubMed  Google Scholar 

  48. Dewar ML, Blundell PE, Lidstone D, et al. Effects of abdominal aneurysmectomy, aortoiliac bypass grafting and angioplasty on male sexual potency: a prospective study. Can J Surg. 1985;28(2):154–6. 159.

    CAS  PubMed  Google Scholar 

  49. Goldwasser B, Carson CC, Braun SD, et al. Impotence due to the pelvic steal syndrome: treatment by iliac transluminal angioplasty. J Urol. 1985;133(5):860–1.

    CAS  PubMed  Google Scholar 

  50. Angelini G, Pezzini F, Mucci P. Arteriosclerosis and impotence. Minerva Psichiatr. 1985;26(4):317–53.

    Google Scholar 

  51. Urigo F, Pischedda A, Maiore M, et al. Role of arteriography and percutaneous transluminal angioplasty in the diagnosis and treatment of arterial vasculogenic impotence. Radiol Med. 1994;88(1–2):86–92.

    CAS  PubMed  Google Scholar 

  52. Wang TD, Lee WJ, Chen WJ, et al. Comprehensive assessment of prevalence and distribution of obstructive pelvic arterial lesions by computed tomography angiography in patients with erectile dysfunction. J Am Coll Cardiol. 2013;62:B160.

    Article  Google Scholar 

  53. Rogers JH, Karimi H, Kao J. Internal pudendal artery stenoses and erectile dysfunction: correlation with angiographic coronary artery disease. Catheter Cardiovasc Interv. 2010;76(6):882–7.

    Article  PubMed  Google Scholar 

  54. Jarow JP, DeFranzo AJ. Long-term results of arterial bypass surgery for impotence secondary to segmental vascular disease. J Urol. 1996;156(3):982–5.

    Article  CAS  PubMed  Google Scholar 

  55. Simonsen U, Garcia-Sacristan A, Prieto D, et al. Penile arteries and erection. J Vasc Res. 2003;39(4):283–303.

    Article  Google Scholar 

  56. Prieto D. Physiological regulation of penile arteries and veins. Int J Impot Res. 2008;20(1):17–29.

    Article  CAS  PubMed  Google Scholar 

  57. Anderson KE. Pharmacology of lower urinary tract smooth muscles and penile erectile tissues. Pharmacol Rev. 1993;45(3):253–308.

    CAS  Google Scholar 

  58. Andersson KE, Wagner G. Physiology of penile erection. Physiol Rev. 1995;75(1):191–236.

    CAS  PubMed  Google Scholar 

  59. Manabe K, Heaton JP, Morales A, et al. Pre-penile arteries are dominant in the regulation of penile vascular resistance in the rat. Int J Impot Res. 2000;12(3):183–9.

    Article  CAS  PubMed  Google Scholar 

  60. Zweifach BW, Lipowsky HH. Pressure-flow relations in blood and lymph microcirculation. In: Handbook of physiology, Section 2: the cardiovascular system, vol. 4, microcirculation Part 1, Chapter 7. Bethesda, MD: American Physiological Society; 1984. p. 231–307.

    Google Scholar 

  61. Hannan JL, Blaser MC, Oldfield L, et al. Morphological and functional evidence for the contribution of the pudendal artery in aging-induced erectile dysfunction. J Sex Med. 2010;7(10):3373–84.

    Article  PubMed  Google Scholar 

  62. Hannan JL, Blaser MC, Oldfield L, et al. Impact of hypertension, aging, and antihypertensive treatment on the morphology of the pudendal artery. J Sex Med. 2011;8(4):1027–38.

    Article  CAS  PubMed  Google Scholar 

  63. Folko B. Physiological aspects of primary hypertension. Physiol Rev. 1982;62(2):347–504.

    Google Scholar 

  64. Huguet JF, Clerissi J, Juhan C. Radiologic anatomy of pudendal artery. Eur J Radiol. 1981;1(4):278–84.

    CAS  PubMed  Google Scholar 

  65. Bahren W, Gall H, Scherb W, et al. Arterial anatomy and arteriographic diagnosis of arteriogenic impotence. Cardiovasc Intervent Radiol. 1988;11(4):195–210.

    Article  CAS  PubMed  Google Scholar 

  66. Bruhlmann W, Pouliadis G, Zollikofer C, et al. Arteriography of the penis in secondary impotence. Urol Radiol. 1982;4(4):243–9.

    Article  CAS  PubMed  Google Scholar 

  67. Buvat J, Lemaire A, Besson P, et al. Lack of correlations between penile thermography and pelvic arteriography in 29 cases of erectile impotence. J Urol. 1982;128(2):298–9.

    CAS  PubMed  Google Scholar 

  68. Buvat J, Lemaire A, Buvat-Herbaut M, et al. Comparative investigations in 26 impotent and 26 nonimpotent diabetic patients. J Urol. 1985;133(1):34–8.

    CAS  PubMed  Google Scholar 

  69. Ramanathan R, Mulhall J, Rao S, et al. Predictive correlation between the International Index of Erectile Function (IIEF) and Sexual Health Inventory for Men (SHIM): implications for calculating a derived SHIM for clinical use. J Sex Med. 2007;4(5):1336–44.

    Article  PubMed  Google Scholar 

  70. Yeung AC, Leon MB, Jain A, et al. Clinical evaluation of the resolute zotarolimus-eluting coronary stent system in the treatment of de novo lesions in native coronary arteries: the resolute us clinical trial. J Am Coll Cardiol. 2011;57(17):1778–83.

    Article  PubMed  Google Scholar 

  71. Gray RR, Keresteci AG, St Louis EL, et al. Investigation of impotence by internal pudendal angiography: experience with 73 cases. Radiology. 1982;144(4):773–80.

    Article  CAS  PubMed  Google Scholar 

  72. Schwartz AN, Freidenberg D, Harley JD, et al. Nonselective angiography after intracorporal papaverine injection: an alternative technique for evaluating penile arterial integrity. Radiology. 1988;167(1):249–53.

    Article  CAS  PubMed  Google Scholar 

  73. Kim ED, Owen RC, White GS, et al. Endovascular treatment of vasculogenic erectile dysfunction. Asian J Androl. 2014. doi: 10.4103/1008-682X.143752. [Epub ahead of print].

    Google Scholar 

  74. Cassese S, Byrne RA, Tada T, et al. Incidence and predictors of restenosis after coronary stenting in 10,004 patients with surveillance angiography. Heart. 2014;100(2):153–9.

    Article  PubMed  Google Scholar 

  75. Alfonso F, Byrne RA, Rivero F, et al. Current treatment of in-stent restenosis. J Am Coll Cardiol. 2014;63(24):2659–73.

    Article  PubMed  Google Scholar 

  76. Remkes WS, Somi S, Roolvink V, et al. Direct drug-eluting stenting to reduce stent restenosis: a randomized comparison of direct stent implantation to conventional stenting with pre-dilation or provisional stenting in elective PCI patients. JACC Cardiovasc Interv. 2014;7(7):751–8.

    Article  PubMed  Google Scholar 

  77. Nojima Y, Yasuoka Y, Kume K, et al. Switching types of drug-eluting stents does not prevent repeated in-stent restenosis in patients with coronary drug-eluting stent restenosis. Coron Artery Dis. 2014;25(8):638–44.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Philip F, Shishehbor MH, Desai MY, et al. Characterization of internal pudendal artery atherosclerosis using aortography and multi-detector computed angiography. Catheter Cardiovasc Interv. 2013;82(4):E516–21.

    PubMed  Google Scholar 

  79. Aversa A, Sarteschi LM. The role of penile color-duplex ultrasound for the evaluation of erectile dysfunction. J Sex Med. 2007;4(5):1437–47.

    Article  PubMed  Google Scholar 

  80. Valji K, Bookstein JJ. Diagnosis of arteriogenic impotence: efficacy of duplex sonography as a screening tool. Am J Roentgenol. 1993;160(1):65–9.

    Article  CAS  Google Scholar 

  81. Quam JP, King BF, James EM, et al. Duplex and color Doppler sonographic evaluation of vasculogenic impotence. Am J Roentgenol. 1989;153(6):1141–7.

    Article  CAS  Google Scholar 

  82. Spiliopoulos S, Shaida N, Katsanos K, et al. The role of interventional radiology in the diagnosis and management of male impotence. Cardiovasc Intervent Radiol. 2013;36(5):1204–12.

    Article  PubMed  Google Scholar 

  83. Wang TD, Lee WJ, Yang SC, et al. Safety and six-month durability of angioplasty for isolated penile artery stenoses in patients with erectile dysfunction: a first-in-man study. EuroIntervention. 2014;10(1):147–56.

    Article  PubMed  Google Scholar 

  84. Pereira JA, Bilhim T, Rio Tinto H, et al. Radiologic anatomy of vasculogenic erectile dysfunction: a systematized approach. Acta Med Port. 2013;26(3):219–25.

    PubMed  Google Scholar 

  85. Izumi K, Kawanishi Y, Muguruma H, et al. Virtual cavernoscopy: a novel diagnostic tool for use in the corpus cavernosal lumen in patients with erectile dysfunction. BJU Int. 2011;108(8):1316–20.

    Article  PubMed  Google Scholar 

  86. Pretorius ES, Siegelman ES, Ramchandani P, et al. MR imaging of the penis. Radiographics. 2001;21:S283–99.

    Article  PubMed  Google Scholar 

  87. John H, Kacl GM, Lehmann K, et al. Clinical value of pelvic and penile magnetic resonance angiography in preoperative evaluation of penile revascularization. Int J Impot Res. 1999;11(2):83–6.

    Article  CAS  PubMed  Google Scholar 

  88. Yamaki K, Saga T, Doi Y, et al. A statistical study of the branching of the human internal iliac artery. Kurume Med J. 1998;45(4):333–40.

    Article  CAS  PubMed  Google Scholar 

  89. Bilhim T, Pereira JA, Fernandes L, et al. Angiographic anatomy of the male pelvic arteries. Am J Roentgenol. 2014;203(4):W373–82.

    Article  Google Scholar 

  90. Herman A, Adar R, Rubinstein Z. Vascular lesions associated with impotence in diabetic and nondiabetic arterial occlusive disease. Diabetes. 1978;27(10):975–81.

    Article  CAS  PubMed  Google Scholar 

  91. Struyven J, Gregoir W, Giannakopoulos X, et al. Selective pudendal arteriography. Eur Urol. 1979;5(4):233–42.

    CAS  PubMed  Google Scholar 

  92. Nessi R, De Flaviis L, Bellinzoni G, et al. Digital angiography of erectile failure. Br J Urol. 1987;59(6):584–9.

    Article  CAS  PubMed  Google Scholar 

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  1. Department of Urology, Southern Illinois University School of Medicine, 301 North 8th Street, 19665, Springfield, IL, 62794-9665, USA

    Joshua D. Ring MD & Aye A. Lwin BS

  2. Department of Urology, Southern Illinois University School of Medicine, 301 North 8th Street, 19665, Springfield, IL, 62794-9665, USA

    Tobias S. Köhler MD, MPH

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  1. Southern Illinois University School of Medicine, Springfield, Illinois, USA

    Tobias S. Köhler

  2. Division of Urology Department of Surgery, Southern Illinois University School of Medicine Hospital Affiliates, Springfield, Illinois, USA

    Kevin T. McVary

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Ring, J.D., Lwin, A.A., Köhler, T.S. (2016). Endovascular Approaches to Penile Arterial Revascularization for Vasculogenic Erectile Dysfunction. In: Köhler, T., McVary, K. (eds) Contemporary Treatment of Erectile Dysfunction. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-31587-4_16

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