The Value of Duplex Ultrasound Measurements in the Penile Flaccid State for the Assessment of Cavernosal Arterial Condition In Patients with Erectile Dysfunction.

Abstract

The aim of this work was to establish if duplex parameters obtained for the assessment of the patency of cavemosal arteries in the penile flaccid state can give sufficient clinical infonnation without the use of intracavemosal injection of vasodilatory drugs. We assessed Diameter of both cavernosal arteries, PSV, EDV, Rl, and acceleration time in both cavemosal arteries in I 00 unselected patients with erectile dysfunction before and after injection of 30 mg papaverine +1 mg phentolamine mixture, theses parameters were also assessed in 50 nonnal individuals with no erectile problems without use of intracavemosal injection (as control) theses control group was classified into 4 age subgroups. The results of the study can be summarized as follows: (1) There was a significant relationship between basal PSV and dynamic PSV and between basal acceleration and dynamic PSV (P value 0.039, 0.036 respectively);(2) A basal PSV2:12.62 em/sec was predictive of a dynamic PSV2:30 em/sec in 42/76(76.4%) of the patients, while a basal PSV <12.6 em/sec was predictive of dynamic PSV<30 em/sec in 11/24 (45.8%) of patients with overall accuracy 53%;(3) A basal acceleration 2:2.28 m/sec2 was predictive of dynamic PSV2:30 em/sec in 44/49 (89.8%) of patients, while a basal acceleration <2.28 m/sec2 was predictive of a dynamic PSV<30 em/sec in 19/51 (37.3%) of patients with overall accuracy 63%.(4) After the age of 50, there is significant reduction at that age in potent males. In conclusion, measurement of basal PSV and basal acceleration is highly specific test but with poor specificity and poor overall accuracy and so cannot replace the use of intracavemosal injection in the assessment of cavemosal arterial condition.