Pelvic steal syndrome

PELVIC STEAL SYNDROME GORDON

R. GLUCKMAN

A

24-year-old man presented with complaints of penile detumescence with exercise. History was significant for a gunshot wound to the right iliac vasculature and a left-to-right femoral bypass graft (Fig. 1, left [arrow]). There was no apparent terminal blood flow to the penis on arteriography

AND TOM E LUE

(Fig. 1, right). Penile duplex ultrasonography (Fig. 2) after injection of prostaglandin El revealed good flow within the cavernosal and right dorsal arteries with a good erection, but detumescence with deep knee bends. Given the minimal pressure difference (5 mmHg) , measured intraop-

FIGURE 1

FIGURE 2.

From the University of California School of Medicine, San Francisco, California Reprint requests: Tom F. Lue, M.D., Department of Urology, University of California, San Francisco, San Francisco, CA 94143-0738 Submitted: September 21, 1995, accepted: December 12, 1995

426

eratively, between the epigastric and right dorsal arteries, an artery-to-artery revascularization was not warranted. To prevent a steal syndrome from the femoral bypass with exercise, the patient underwent a successful left-epigastric-to-dorsal-vein revascularization. uROLcx?Y@ 47 (31, 1996