Temporal Changes in Shear Wave Elastography and Doppler Ultrasound Parameters for Assessing Erectile Dysfunction

This study aimed to explore the temporal changes in shear wave elastography (SWE) metrics before and after intracavernosal injection (ICI) in patients with different erectile dysfunction (ED) subtypes and to analyze the relationships between spectral Doppler ultrasound parameters and hardness grades according to the Schramek classification.

Patients with ED were enrolled and categorized into vascular and non-vascular groups. The peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), and Young's modulus SWE values were measured before ICI and at 1, 3, 5, 10, 15, 20, and 30 min post-ICI. Additionally, the Schramek grades were assessed, with grades II and III classified as low hardness and grades IV and V classified as high hardness.

One hundred and five men with a mean age of 35.42 (29-55) y were evaluated. A significant interaction between time points and group type was observed in SWE values (coefficient = -0.1491, p = 0.005), with vascular patients exhibiting a distinct late-phase increase in SWE values from 15-30 min post-ICI. After ICI, SWE values decreased significantly in both groups (p < 0.05); EDV was significantly higher (p < 0.05) and RI was significantly lower (p < 0.05) in the low-hardness group (Schramek II-III) than in the high-hardness group (Schramek IV-V).

SWE can reflect dynamic changes of penile tissue elasticity post-ICI, and combining SWE with spectral Doppler ultrasound enhances the assessment of ED subtypes and penile hardness, providing a more comprehensive diagnostic basis.