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By far the most widely recognized vascular etiologies responsible for organic erectile dysfunction can be divided into arterial insufficiency, corporoveno\u2010occlusive dysfunction or mixed type, with corporoveno\u2010occlusive dysfunction representing the most common finding. In arteriogenic erectile dysfunction, corpora cavernosa show lower oxygen tension, leading to a diminished volume of cavernosal smooth muscle and consequential corporoveno\u2010occlusive dysfunction. Current studies support the contention that corporoveno\u2010occlusive dysfunction is an effect rather than the cause of erectile dysfunction. Surgical interventions have consisted primarily of penile revascularization surgery for arterial insufficiency and penile venous surgery for corporoveno\u2010occlusive dysfunction, whatever the mechanism. However, the surgical effectiveness remained debatable and unproven, mostly owing to the lack of consistent hemodynamic assessment, standardized select patient and validated outcome measures, as well as various surgical procedures. Penile vascular surgery has been disclaimed to be the treatment of choice based on the currently available guidelines. However, reports on penile revascularization surgery support its utility in treating arterial insufficiency in otherwise healthy patients aged &lt;55\u00a0years with erectile dysfunction of late attributable to arterial occlusive disease. Furthermore, it is noteworthy that penile venous surgery might be beneficial for selected patients with corporoveno\u2010occlusive dysfunction, especially with a better understanding of the innovated venous anatomy of the penis. Penile vascular surgery might remain a viable alternative for the treatment of erectile dysfunction, and could have found its niche in the possibility of obtaining spontaneous, unaided and natural erection.<\/jats:p>","DOI":"10.1111\/iju.14157","type":"journal-article","created":{"date-parts":[[2019,12,7]],"date-time":"2019-12-07T23:56:20Z","timestamp":1575762980000},"page":"117-133","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Surgical niche for the treatment of erectile dysfunction"],"prefix":"10.1111","volume":"27","author":[{"given":"Cheng\u2010Hsing","family":"Hsieh","sequence":"first","affiliation":[{"name":"Department of Urology Taipei Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Taipei Taiwan"},{"name":"School of Medicine Buddhist Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geng\u2010Long","family":"Hsu","sequence":"additional","affiliation":[{"name":"Microsurgical Potency Reconstruction and Research Center Hsu\u2019s Andrology Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang\u2010Jen","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Urology Taipei Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Taipei Taiwan"},{"name":"School of Medicine Buddhist Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Shei\u2010Dei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology Taipei Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Taipei Taiwan"},{"name":"School of Medicine Buddhist Tzu Chi University Hualien Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Ping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology National Taiwan University Hospital Taipei Taiwan"},{"name":"School of Medicine National Taiwan University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju\u2010Ton","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Urology National Taiwan University Hospital Taipei Taiwan"},{"name":"School of Medicine National Taiwan University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2005.20103.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079904125003467"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2009.01624.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00007085"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2010.01932.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijir.3900270"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)63311-1"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198912143212406"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(84)90208-5"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)45697-7"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)41489-3"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)41305-X"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-6911-9.00023-2"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)43911-5"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2011.02226.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2010.02062.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)65578-2"},{"key":"e_1_2_8_19_1","first-page":"117","article-title":"The three\u2010dimensional structure of the human tunica albuginea: anatomical and ultrastructural level","volume":"4","author":"Hsu GL","year":"1992","journal-title":"Int. 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