Nuclear medicine in problems of fertility and impotence

Nuclear medicine techniques may be used to test fallopian tube patency and penile vascular inflow and outflow. Radionuclide hysterosalpingography (HSP) is a readily performed method of evaluating fallopian tube patency, and is believed to be more physiologic and functionally informative than the accepted radiologic method of contrast HSP. The test is simple to perform and interpret and offers an accurate alternative to the contrast examination. For scintigraphic evaluation of impotence, blood pool studies are most useful in assessing the integrity of arterial inflow, but may also be used to generate indices of venous leak. Washout of xenon after subcutaneous injection, in the flaccid state, has been used as a measure of baseline penile perfusion, as has intracavernosal injections in the flaccid penis. Intracavernosal xenon washout during erection seems the most useful method of testing venous integrity. Washout using technetium-99m (99mTc)-labeled red blood cells (99mTc-RBC) may emerge as a convenient alternative to the more technically difficult xenon examinations.