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Usefulness of power Doppler ultrasonography in evaluating erectile dysfunction
1Department of Urology, Pomeranian Academy of Medicine, ul. Powstanców Wlkp. 72, 70-111 Szczecin, Poland. golubinski@interia.com.pl
Objective:
To evaluate deep penile arterial flow after an intracavernosal injection with papaverine in patients with erectile dysfunction (ED).
Patients And Methods:
Twenty patients with ED were evaluated using power Doppler ultrasonography with a linear probe (8 MHz). Diagnostic tests were undertaken after an intracavernosal injection with 40 mg papaverine. The peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI) were analysed.
Results:
After injecting papaverine, seven patients had a normal erection and appropriate waveform patterns; their mean PSV was 30.7 cm/s, the EDV 4.42 cm/s and the RI 0.85. There was tumescence and elongation of the penis with no rigidity in eight patients; their mean PSV was 23.9 cm/s, the EDV 7.34 cm/s and the RI 0.72. There was no erection in five patients. The abnormal flow values showed insufficient arterial vessels in a quarter of the men, venous leakage in 15% and mixed ED in 20%.
Conclusion:
The power Doppler technique allows the accurate location and evaluation of deep penile arteries. Vascular pathology may be differentiated after an intracavernosal injection with a vasomotor agent. Recognising the pathological pattern assists in choosing the best method of treatment.