Duplex Doppler scanning with prostaglandin E1 in the diagnosis of cavernovenous leakage

The aim of this study was to find out the normal response of the duplex Doppler (DD) parameter resistance index (RI) during a high dose prostaglandin E1 (40 micrograms) induced erection and to evaluate the clinical usefulness of DD scanning in the diagnosis of cavernovenous leakage (CVL). The results of DD scanning and cavernometry were compared in 10 potent control subjects and 82 impotent patients RI was > or = 1 in all control subjects later than 10 min after the intracavernous injection and RI at 20 min after the injection (RI20) was chosen as a clinical parameter. An inverse correlation (r = -0.69, p < 0.001) between RI20 and the maintenance flow (MF) at 150 mm Hg (MF150) was demonstrated. Sensitivity and specificity of RI20 (values < 1 indicating CVL) as a test of CVL (MF150 > 18 ml/min) were 89% and 86%, respectively. In conclusion, the measurement of RI20 in DD scanning after an adequate pharmaco-stimulation is a reliable, noninvasive method in the diagnosis of CVL.