By J.-F. Ginestié, A. Romieu
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Extra resources for Radiologic Exploration of Impotence
Origin There is less variety in the origin of the internal pudendal than in that of the obturator artery. In our series the internal pudendal artery arises in 73 per cent of the cases from the trunk it shares with the inferior gluteal artery, a trunk which sometimes is extremely short; in 14 per cent of the cases from a terminal bouquet (arborization) of the internal iliac artery; and in 11 per cent of the cases from a terminal trifurcation of the internal iliac artery. This trifurcation can be one of two patterns, grouping either superior gluteal, inferior gluteal, and internal pudental arteries, or common trunk of gluteal arteries, internal pudendal, and obturator arteries.
In amputation ofthe internal iliac artery we have never observed a revascularization at a more distal level. arteriography of internal pudendal artery/65 Lesions of the pelvic and gluteal portions of the internal pudendal artery Atheromatous notches are present. Pronounced stenoses or amputations are exceptional. In these cases, we have not observed any distal revascularization. Lesions of the ischiorectal portion of the internal pudendal artery The signs are analogous to those of the two upper segments: atheromatous notches, pronounced stenoses and, exceptionally, amputations sometimes associated with distal revascularization.
Two consequences result. We must (1) direct the vascular surgeon toward operative techniques which do not jeopardize a possible secondary operation for impotence; and (2) make a second-ary arteriographic exploration of this impotence if it persists after the 0 bstruction of the aortoiliac axes has been elimimited. Lesions of the internal iliac artery Amputations or pronounced stenoses of the internal iliac artery which are not associated with lesions developed from the common and external iliac are the exception.
Radiologic Exploration of Impotence by J.-F. Ginestié, A. Romieu