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Urology/Pulsing Artery

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QUESTION: Hello,

I recently asked a question about my artery but was unable to ask a follow up due to losing my email. Anyways, you said that the dorsal artery doesnt affect the erection, but how come people would do surgery on it if it didn't affect anything. Like in this article below http://www.sexualmed.org/index.cfm/sexual-health-treatments/for-men/penile-revas

ANSWER: Mike:

The superficial dorsal artery is not primarily involved in erection function; that is the responsibility of the cavernosal arteries.  The article you quote was written by a noted expert, Dr. Irwin Goldstein, and he is technically correct but you will notice that it refers only to a very select group of patients who have bypassable and identifiable lesions.  The overwhelming majority do not have this.  A bypass involving the dorsal artery can help some people with blockages due to collaterals to the cavernosal vessels, but these are the exceptions.

---------- FOLLOW-UP ----------

QUESTION: I don't understad...and is a pulse in an artery that feels hard a sign of blockage?

Answer
Mike:

OK, I'll simplify.  In a very small and select group of patients who have a very specific and localized lesion, it may be possible for such a surgery as described to help.  But the overwhelming majority of patients with ED do not have such a lesion which is usually the result of some kind of trauma or injury.  There is also evidence that such surgeries may not hold up or last very long.

The primary arteries that support erection function are the pudendal arteries, not the dorsal superficial.  The pudendal arteries are way too deep in the pelvis to be felt.

A palable or visible pulse only means there is a sizeable artery close enough to the skin surface to be noticed.  It does not indicate a blockage.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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