ABSTRACT
It is important to get the patient to relax as much as possible, since anxiety compromises erectile response. Such a situation is not easily obtained considering the invasiveness of the procedure. The distal two thirds of the penis are swabbed with antiseptic. Into one of the corpora cavernosa, an 18F butterfly needle is inserted at a point between the proximal two-thirds and the distal third of the penis. This is important because in the proximal penis there is a septum between the corpora, which is absent distally. This allows for bilateral perfusion of vasoactive drugs and contrast medium. Into the other corpus at the same level, a 21F needle is inserted. That the needles are correctly sited is evidenced by blood refluxing from them. If no blood is seen, a small amount of contrast can be injected under fluoroscopic control. If the needles are correctly sited, the contrast will be seen to flow easily from the tip of the needle. If not correctly sited, contrast will pool at the end of the needle and the patient will experience a sharp localized pain.
