A new method to quantify penile erection hardness: real-time ultrasonic shear wave elastography

Abstract

Background: An important indicator of penile erectile function is erection hardness (EH), which is currently evaluated by the semi-quantitative erectile hardness score (EHS). EH increases continuously during the course of an erection, so although it is statistically a continuous variable, the EHS is a grade variable. We propose a new method for real-time quantitative measurement of penile EH using ultrasonic shear wave elastography (SWE). Methods: The study group comprised 40 patients with erectile dysfunction (ED) and 20 normal controls who all underwent real-time SWE to measure tissue stiffness (Young's modulus, YM) of the penile corpus cavernosum and tunica albuginea during erection, at rest and at different EH grades induced by intracavernosal injection (ICI) of prostaglandin. The examiner gently placed the high frequency probe on the ventral penis and got the two-dimensional longitudinal US image of penis, then switched to SWE mode, the appropriate region of interest (ROI) was selected, then a 3-5 mm circle ("Q-box") was automatically set to by machine to measure the SWE of the corpus cavernosum and tunica albuginea on the left side. Results: In both the ED patients and normal controls, YM slightly decreased in the corpus cavernosum during erection but the stiffness of tunica albuginea increased significantly with increasing EH (resting:

Role of shear wave elastography (SWE) in erectile dysfunction patients for evaluation of daily tadalafil treatment outcome

“…Our results in the previously mentioned aspect go down the same track of Hao et al (Cheng et al, 2020) as they reported higher elastography results in their evaluation of erection hardness in patients with ED than in healthy controls and stated 13 and 10 kpasc for each group during the resting phase respectively.…”

“…Our results in the previously mentioned aspect go down the same track of Hao et al (Cheng et al, 2020) as they reported higher elastography results in their evaluation of erection hardness in patients with ED than in healthy controls and stated 13 and 10 kpasc for each group during the resting phase respectively. Also, our data are in line with Inci et al in their correlation between age and SWE as higher values were in the older age group who expected to have higher cavernosal insults (Inci et al, 2017).…”

Role of shear wave elastography measured in the flaccid state in predicting arteriogenic erectile dysfunction

“…We speculated that the blood supply from the cavernous artery in the flaccid state was the main factor influencing the SWE value in AED and healthy subjects. A study evaluating the relationship between the SWE value of CCP and the erectile hardness demonstrated that the value of SWE (12.90 ± 2.06 kPa) in ED patients was higher than that (9.82 ± 1.92 kPa) in normal controls (Cheng et al., 2020). Its conclusions were consistent with our study, but it cannot divide ED into different original.…”

The penile ultrasound study: an unnecessary exam or an ace in the hole?

“…But if we take a look at further concrete applications that will surely find space in the not too distant future, there are the use of PU as a follow-up tool for patients with vasculogenic ED treated with LiST [12] and then the application of ultrasonic shear wave elastography as potential reliable and objective clinical imaging index indicator for evaluating penile hardness [13].…”