[Color-Doppler ultrasonography in the diagnostic evaluation of erectile dysfunction]

Color-Doppler sonography (CDS) of the cavernosal arteries has received considerable attention since its description in 1985 by Lue et al. Color and Spectral Doppler analysis, provides a useful noninvasive means of evaluating both morphologic and hemodynamic penile abnormalities. CDS is the best method in diagnostic evaluation of patients with erectile dysfunction. It assesses the integrity of the arterial supply to the penis and provides some useful information on the veno-occlusive mechanism. Because the arterial diameter and flow rate change during the different phases of erection CDS is performed after pharmacostimulation with vasoactive agents. Purpose of this study is diagnostic evaluation patients with erectile dysfunction.

We studied 60 patients suspected for vasculogenic ED, and 30 patients suspected for psyhogenic ED, assessing the morphodynamic features of cavernosal arteries by Color-Doppler sonography and their response to contravaernosal injection of prostaglandin E1 (PgE1) and oral dose of Sildenafil citrate. Morphodynamic parameters evaluated by color Doppler sonography included: peak systolic velocity, endodiastolic velocity, inner arterial diameter, index and acceleration of penile blood flow. Patients were divided in the groups: A group (A1--10 patients < 35 years of age, A2--20 patients > 35 years of age) underwent pharmacotest with ICI PgE1; B group (B1--8 patients < 35 years of age, B2--22 patients 35 years age) were tested with oral dose of Sildenafil citrate and C group--30 patients who were also tested with the same drug.

The CDS may be used to evaluate the hemodynamic parameters of the erectile dysfunction. Arterial insufficiency is suspected with poor blood flow, while veno-occlusive dysfunction is inferred in the face of adequate blood flow and poor erectile response.