[Erectile dysfunction of arterial origin. Vascular study of the penis with Doppler ultrasonography]

The etiological diagnosis of an erectile dysfunction usually requires a study of penis vascularization. The arterial origin involves a high percentage of erectile dysfunctions. The eco-doppler allows to perform the study in a fast, non-invasive and effective way, providing information on the morphological aspects of arteries and flow parameters. This paper reports on a study conducted in 151 subjects, aged 27-80 years, where the cause of impotence was arterial; the existence of clinical signs of vascular deficit in other domains had already suggested the condition in a group (36 subjects), while the another group (115) had no clinical symptoms and was diagnosed through eco-doppler. 75.5% were smokers and 83.1% hypertensive. All subjects underwent a baseline study, repeated in 148 after intracavitary injection (ICI). The arteries were difficult to identify at rest, but easier after ICI, presenting morphological features which were suggestive of disease: twisted course, irregular lumen, thickened walls. Flow parameters at rest presented no differences between groups, both speed (p < 0.001) and flow time (p < 0.05) being lower than in subjects with no vascular disease. Only 25.7% reached full erection with ICI, beats being noticed in 44 (91.9%). After administration of the drug there was a significant increase in systolic speed (p < 0.001), rising to 16 +/- 4.9 cm/s vs 34.7 +/- 9.3 cm/s in subjects with no vascular disease (p < 0.001). Flow time increases after ICI, reaching 345 +/- 215 msec, less than in healthy subjects (p < 0.001). RI, highly variable at rest, does not change significantly after ICI, 0.71 +/- 0.11, lower than subjects with no disease (p < 0.001). The increases seen in flow speed are greater in subjects with no ischaemic symptomatology (p < 0.01), same as RI (p < 0.05), and reveals a better arterial response. Those who obtain full erection reach greater RI (0.77 +/- 0.13) than those without full erection (0.68 +/- 0.08) (p < 0.001).