Cavernosometry can be used to diagnose a venous leak in a man with erectile dysfunction. Although largely replaced by Doppler ultrassonography it may still occasionally be performed.
Method:
(1) A small butterfly needle is inserted into each corpus cavernosum on the lateral surface of the penis with the needle inserted towards the head of the patient.
(2) A pressure transducer is attached to one line.
(3) An infusion pump is attached to the second line and heparinized normal saline is infused at a constant rate.
Variables in the procedure:
(1) whether or not a drug (papaverine, prostaglandin E1) is used to achieve an erection
(2) infusion rate of the fluid
(3) reference pressure
Criteria for a venous leak:
(1) higher than normal infusion rate to achieve and maintain an erection in a patient not receiving an intracavernosal injection
(2) higher than normal infusion rate required to maintain an erection in a patient receiving an intracavernosal injection
(2) rapid detumescence once the infusion is stopped (pressure drop within 30 seconds)
|
Conditions Reported in the Literature |
Criteria for Excessive Infusion Rate |
|
intracavernosal papaverine and intracavernosal pressure 150 mm Hg (Kayigil et al) |
> 5 mL/min |
|
intracavernosal papaverine and minimum infusion rate to maintain erection (Cakan et al) |
> 35 mL/min to get an erection and > 30 mL/min to maintain |
|
intracavernosal papaverine or prostaglandin and intracavernosal pressure 90 mm Hg (Benson) |
> 10 mL/min |
|
infusion to achieve and maintain erection without drug injection (Malhotra et al) |
> 150 mL/min to get an erection and > 70 mL/min to maintain |
|
infusion to achieve and maintain erection without drug injection (Lewis) |
> 100 mL/min to maintain |
|
intracavernosal papaverine and minimum infusion rate to maintain erection (Lewis et al) |
> 50 mL/min definite; >= 30 mL/min possible |
Limitations:
• The procedure is invasive.
• The procedure is nonstandardized.
• Expertise is required to interpret the results.
Specialty: Urology
ICD-10: ,
