Doctors in a Welsh hospital have performed a pioneering operation to treat erectile dysfunction (ED).
The operation involves surgically inserting a stent into the main artery of the penis. The treatment could be useful in the case of nearly 30% of patients with ED.
Consultant cardiologist Dr Nick Ossei-Gerning of the University Hospital of Wales, Cardiff, and Dr Andy Wood, an interventional radiologist, became the first in Europe to perform the operation last week.
Half of men over the age of 40 suffer from erectile dysfunction at some point or another. Viagra can increase blood flow to the penis even if there is a 70% blockage, but when that blockage is 90%, there is not enough room for blood to get through to the penis - even with the help of Viagra.
"The interest in stenting came from the fact it has become quite clear that there is a group of patients with ED - around 30% - for whom nothing works," explained Dr Ossei-Gurnin.
"For these patients it may well be that the problem is proximal narrowing of the penile artery."
To find out if this is the cause, Dr Ossei-Gurnin injects a coloured dye into the artery in question using a catheter and then takes a series of x-rays to see if the thinner section of artery shows up.
If it does, the consultant can use a stent - an artificial tube which acts to keep the artery open - by inserting it through arteries in the groin, writes Clare Hutchinson in Western Mail.
The procedure is little different to that commonly used for keeping arteries around the heart open to prevent heart disease and strokes and can be a longer-term answer to ED.
Dr Ossei-Gurnin now has another four such operations planned, and if they continue to be as successful as the first, the consultant believes the operation could become a staple on the NHS.
He said: "It is going to explode - I guarantee it.
"Part of the reason why I fought so hard for this was because we wanted to plant the flag of being the first to do it. At the moment we are the only hospital in the UK doing it and there are only three cardiologists that I know of who are interested - but hopefully now that is going to change. We now have so much coronary experience that we generally know what procedure works and what doesn't work so we are more than ready to take this on."
Dr Ossei-Gurnin says the hospital hopes to target two types of patients with the surgery. Firstly, those who come to the hospital for direct help with erectile dysfunction. Those men are at higher risk of heart problems and will need to be tested. They may then be recommended for the new erectile dysfunction operation. The second type of patient who they will refer for the procedure is heart patients. Doctors can ascertain how clogged-up patients' arteries are using food dye (inserted into the artery using a catheter) and x-ray analysis.
Last year the US media reported of a study on using stents to treat ED, involving 50 patients at 10 separate medical centers.
Dr. Jerome Richie, the chief of urology at Brigham and Women's Hospital in Boston said that the surgery might help younger men stating, "I would foresee this stent as an application for younger individuals who have had traumatic injuries that decrease arterial inflow. Other than that selected group, I do not foresee widespread applicability."
The study is called Zen. According to Reuters, a lead researcher Dr. Jason Rogers, director of interventional cardiology at UC Davis Medical Center in Sacramento, stated that there has been an established link between coronary artery disease and erectile dysfunction. In regards to the study and this link, Rogers states, "Based on this evidence, we are investigating the use of stents in pelvic arteries to determine whether it may provide a new treatment approach and enable better response to drug therapies."
The study will also investigate whether the surgery is safe and improves the erectile dysfunction. The pelvic artery stenting results are expected to be out in 2011.
WebMD refers to vascular reconstructive surgery performed to improve the blood supply of the penis in attempts to improve a man's ability to get and maintain an erection. Because the procedure is technically difficult, costly and not always effective, it is very rarely performed, it says
The surgery involves bypassing blocked arteries by transferring an artery from an abdominal muscle to a penile artery so that it creates a path to the penis that bypasses the area of blockage that is inhibiting blood flow to the penis.
Only a small percentage of men may be candidates for this surgery, in particular young men suffering from ED as a result of trauma to the penis and surrounding areas. But the long-term results from this type of surgery have been disappointing with even the best of results showing only 1 out of 20 men improved. However, for younger men with a single damaged blood vessel that occurred as a result of a pelvic or genital injury, the success rate for this treatment is higher (50%-75%), the website reports.