Time-effect of penile color duplex Doppler ultrasound for diagnosing vascular erectile dysfunction

This study aimed to explore the time-effect of color duplex Doppler ultrasound (CDDU) in the diagnosis of vascular erectile dysfunction (ED).

Using a self-control study, we included patients who underwent penile CDDU and cavernosography in our hospital. We compared the arterial peak systolic velocity (PSV) of CDDU among different intervals for the diagnosis of arterial ED. We included 357 patients who were under consideration for vascular ED.

We found significant differences in all the pairwise comparison of PSV in the 1st (0-5 min), 2nd (6-10 min), 3rd (11-15 min), and 4th (16-20 min) 4 intervals after the injection of prostaglandin E1 (p<0.001), except the 11-15 min vs. the 16-20 min interval (p=0.387). Using cavernosography, 294 patients were diagnosed with venous ED. Compared with other intervals, the diagnosis of CDDU 11-15 min after the intracavernous injection of 20 ug prostaglandin E1 (PGE1) had the best consistency with cavernosography (Kappa=0.761; p<0.001). Compared with other intervals, CDDU at 11-15 min had the highest specificity (93.65%), the highest Youden index (0.85), positive likelihood ratio of 14.46, positive predictive value of 98.54%, negative predictive value of 71.08% and a coincidence rate of 92.16%.

Our findings support the increased utilization of CDDU for the diagnosis of both arterial and venous ED. The diagnosis at 11-15 min after intracavernous injection of PGE1 is accurate and stable, which would help to simplify the process and shorten the time of CDDU.