Method:
(1) An erection is achieved, often by injecting papaverine HCl (usually 60 mg) into a cavernosal body.
(2) Systolic blood flow is measured in cm per second (cm/s).
(3) End-diastolic blood flow is measured in cm per second (cm/s).
|
Systolic Blood Flow
|
End-Diastolic Blood Flow
|
Diagnosis
|
|
>= 35 cm/s
|
<= 5 cm/s
|
normal
|
|
25 to 34 cm/s
|
<= 5 cm/s
|
indeterminate arterial blood flow
|
|
< 25 cm/s
|
<= 5 cm/s
|
arterial insufficiency
|
|
>= 35 cm/s
|
> 5 cm/s
|
veno-occlusive disorder
|
|
25 to 34 cm/s
|
> 5 cm/s
|
indeterminate arterial blood flow together with veno-occlusive deficiency
|
|
< 25 cm/s
|
> 5 cm/s
|
mixed arterial insufficiency and veno-occlusive deficiency
|
where:
• Some authors use an end-diastolic blood flow of 4 cm/s as the cutoff for veno-occlusive disease.
• Very high systolic blood flow may be seen in high flow priapism.
Causes of ED with normal Doppler studies:
(1) psychogenic
(2) some neurogenic causes (autonomic neuropathy often associated with veno-occlusive deficiency)
(3) age-related impairment
Limitations:
• The intermediate "gray" zone for systolic blood flow can be frustrating.
• There may be poor correlation between findings on Doppler ultrasonography and veno-occlusive disease as diagnosed by cavernosogram with infusion cavernosometry.
References"
Benson CB, Vickers MA. Sexual impotence caused by vascular disease: Diagnosis with duplex sonography. AJR. 1989; 153: 1149-1153.
Benson CB, Aruny JE, Vicers MA Jr. Correlation of duplex sonography with arteriography in patients with erectile dysfunction. AJR. 1993; 160: 71-73.
Eardley I. Imaging for erectile dysfunction. Current Opinion Urology. 2002; 12: 143-148.
Furst G, Muller-Mattheas V, et al. Venous incompetence in erectile dysfunction" evaluation with colour-coded duplex songraphy and cavernosometry/graphy. Eur Radiol. 1999; 9: 35-41.
Golijanin D, Singer E, et al. Doppler evaluation of erectile function - Part I. Int J Impotence Res. 2007; 19: 37-42.
