Doppler Ultrasound Study of Penis in Men with Systemic Sclerosis: A Correlation with Doppler Indices of Renal and Digital Arteries

Abstract

Erectile dysfunction (ED) prevalence in male systemic sclerosis (SSc) is high and its pathogenesis is unclear. The aim of the study is to assess correlation between Doppler ultrasound indices of penis and kidneys or digital arteries in male systemic sclerosis. Fourteen men with systemic sclerosis were enrolled in this study. Erectile function was investigated by the International Index of Erectile Function-5. Peak systolic velocity, end diastolic velocity, resistive index, pulsative index, and systolic/diastolic ratio were measured on the cavernous arteries at the peno-scrotal junction in the flaccid state, on the interlobar artery of both kidneys and all ten proper palmar digital arteries. Ten (71 percent) patients have an International Index of Erectile Function-5 less than 21. Reduction of penis peak systolic velocity was observed in all SSc subjects. Doppler indices of cavernous arteries correlate with the International Index of Erectile Function-5. The renal and digital arteries resistive index demonstrated a good correlation (p less than 0.0001) with International Index of Erectile Function-5. A positive correlation exists between penis and kidney arteries Doppler indices: end diastolic velocity (p less than 0.05, r=0.54), resistive index (p less than 0.0001, r=0.90), systolic/diastolic ratio (p less than 0.01, r=0.69). A positive correlation was observed between penis and digital arteries Doppler indices: peak systolic velocity (p less than 0.01, r=0.68), end diastolic velocity (p less than 0.01, r=0.75), resistive index (p less than 0.001, r=0.79), systolic/diastolic ratio (p less than 0.05, r=0.59). A correlation exists between arterial impairment of penis and renal or digital arteries.

Left Ventricular Mass and Intrarenal Arterial Stiffness as Early Diagnostic Markers in Cardiorenal Syndrome Type 5 due to Systemic Sclerosis

“…Furthermore, we found that patients with ulcers had a significantly greater LVM compared to patients without skin lesions. Moreover, it is well known that a clinically silent kidney injury in the course of SSc can be detected by Doppler renal ultrasound [21] and that RI correlates with systemic autonomic dysfunction [3], digital ulcers [9] and erectile dysfunction [22]. After analyzing our results, we can postulate that LVM/BSA correlates with intrarenal arterial stiffness as demonstrated by elevated RI, PI and S/D.…”

Erectile dysfunctions in patients with systemic sclerosis

“…The vascular system involvement may manifest itself as pulmonary arterial hypertension which correlates with erectile dysfunction [22]. Similarly, a positive correlation was found between penile blood flow disorders, as well as finger and kidney arteries [25][26][27]. Similarly, the correlation between changes in the microcirculation detected by capillaroscopy and the erectile dysfunction was demonstrated, but the detection of capillaroscopic changes did not allow to predict the occurrence of erectile dysfunction [28].…”

“…Zajęcie układu naczyniowego może wyrażać się tętniczym nadciśnieniem płucnym, które koreluje z zaburzeniami erekcji [22]. Podobnie dodatnią korelację wykazano pomiędzy zaburzeniami przepływu krwi w tętnicach prącia i tętnicach palców oraz tętnicach nerkowych [25][26][27]. Podobnie wykazano zależność zmian w mikrokrążeniu stwierdzonych kapilaroskopowo z zaburzeniami erekcji, ale wykrycie zmian kapilaroskopowych nie pozwalało na przewidywanie wystąpienia zaburzeń erekcji [28].…”

Penile scleroderma: clinical review

“…Кроме того, в специальной литературе данный контингент больных также обойден вниманием. Основное внимание обращено только на наличие эректильной дисфункции у пациентов, страдающих системной склеродермией [1][2][3]. Однако другие проблемы больных ограниченной склеродермией с высыпаниями на коже полового члена в специальной литературе не рассматриваются.…”