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Description

Doppler ultrasonography can be used to measure systolic and diastolic blood flow in the penis. This can be very helpful in identifying patients with vasculogenic erectile dysfunction.


 

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.


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