Colour duplex sonography in the assessment of impotence

We present our experience with colour duplex sonography (Acuson 128) in the assessment of 83 impotent men. Cavernosal artery measurements were taken before and after the intracorporeal injection of papaverine. The peak velocities following papaverine injection correlated well with the degree of clinical response. Percentage diameter change corresponded with some groups of clinical erection grade, although it was not as good a discriminator as peak velocity. Twelve patients with 24 cavernosal arteries were also examined using pharmacological selective arteriography. Correlation between duplex sonography and arteriography showed an accuracy of 87.5%, specificity of 100.0% and sensitivity of 82.4%. All patients with a clinically good response following papaverine injection had peak bilateral cavernosal artery velocities greater than or equal to 25 cm/s. Amongst the remaining suboptimal responders, 18 also had this finding. Fifteen of these underwent pharmacological cavernosography and 14 exhibited venous leakage. Duplex sonography is a valuable and non-invasive tool in the assessment of impotence and can provide valuable information in deciding the course of further evaluation and treatment. The procedure was always completed more quickly with the guidance of colour Doppler.