Technical and anatomic factors in filling of distal portion of internal pudendal artery during arteriography.

Left and right internal pudendal arteriography was performed in 9 nonimpotent male patients (mean age 29 years) who had normal erections. Filling of distal branches of the internal pudendal artery and inter-pudendal anastomoses was improved by superselective catheterization of the anterior trunk of the internal iliac artery or an ischiopudendal trunk, and by the choice of hyperosmolar contrast medium. In the 5 cases where these conditions were fulfilled, filling of the distal branches of internal pudendal arteries was always symmetrical, or showed bifid artery with bilateral distribution on one side, except for the dorsal artery of the penis which appeared to be single in 2 cases. Interdependence between the two internal pudendal arteries was noted in 7 of 9 patients, through either direct anastomosis (7 cases) or bilaterally distributed deep artery of penis (2 cases).