Color Doppler appearance of penile cavernosal–spongiosal communications in patients with severe Peyronie's disease

Bertolotto, Michele; Stefani, Stefano De; Martinoli, Carlo; Quaia, Emilio; Buttazzi, Lorenzo

doi:10.1007/s00330-002-1330-5

Cited by 19 publications

(13 citation statements)

References 18 publications

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“…9 To our knowledge, reverse flow in CSCs has not been reported in the literature. The penis receives its blood supply from the paired internal pudendal arteries.…”

Section: Discussionmentioning

confidence: 81%

Vasculogenic impotence as a symptom in late‐onset Buerger's disease

Yavas

Çalışır

Kaya

2007

J of Clinical Ultrasound

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“…9 To our knowledge, reverse flow in CSCs has not been reported in the literature. The penis receives its blood supply from the paired internal pudendal arteries.…”

Section: Discussionmentioning

confidence: 81%

Vasculogenic impotence as a symptom in late‐onset Buerger's disease

Yavas

Çalışır

Kaya

2007

J of Clinical Ultrasound

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“…They also studied the color Doppler appearance of penile CSCs in 20 patients with severe Peyronie disease; 2 of their 20 patients had arteriogenic dysfunction, but none had reversal of flow in the CSCs. 9 We previously described reversed flow in the CSCs in a 57-yearold patient with ED who had late-onset Buerger disease and concluded that reversed flow in the CSCs was a sign of small-artery obstruction. 4 We used the PSV as the reference standard to diagnose arteriogenic impotence.…”

Section: E B Cmentioning

confidence: 94%

A Sign of Arteriogenic Insufficiency on Penile Doppler Sonography

Yavas

Çalışır

Kaya

et al. 2007

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to evaluate the diagnostic usefulness of determining retrograde flow in the penile cavernosal-spongiosal communications (CSCs) with Doppler sonography. Methods. Thirty-two consecutive men with erectile dysfunction (mean age, 40 years; range, 19-61 years) underwent penile color Doppler sonography. All patients were evaluated for flow direction in the CSCs. Results. Eight of the 32 patients had normal Doppler sonographic findings; 8 had signs of veno-occlusive dysfunction; and 16 had arterial insufficiency. Doppler sonographic examinations of the patients with normal Doppler sonographic findings (100%) and veno-occlusive dysfunction (100%) showed a normal direction of flow in the CSCs. Thirteen of the 16 patients with arterial insufficiency had a normal direction of flow in the CSCs; however, reversal of the flow direction in the CSCs (from the urethral artery back to the cavernosal artery) was observed in the remaining 3 patients. Conclusions. Investigating the direction of flow in the cavernosal artery, CSCs, and urethral artery is not time-consuming and may help establish an accurate diagnosis of arteriogenic impotence, especially in patients with borderline peak systolic flow velocity values. Key words: Doppler sonography; impotence; sonography; vasculogenic. rectile dysfunction (ED), the consistent inability to achieve and maintain an erection sufficient for satisfactory sexual function, results from organic disease in up to 80% of cases. Most of these cases are the result of hemodynamic dysfunction, with arterial insufficiency (in up to 80%) or venous incompetence. 1Various parameters, such as the diameter of the cavernosal artery, peak systolic flow velocity (PSV), degree of arterial dilatation, and acceleration time, have been suggested for the diagnosis of arteriogenic ED, but the PSV is the most accurate indicator of arterial disease. Secondary diagnostic criteria for arteriogenic ED include asymmetry of greater than 10 cm/s in the PSV, an increase in the diameter of the cavernosal artery of less than 75% after intracavernosal injection, focal stenosis in the cavernosal artery, and retrograde arterial flow. Cavernosal-spongiosal communications (CSCs) are vessels connecting the cavernosal and urethral arteries 3 that carry the blood from the cavernosal artery to the

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“…b Color Doppler US shows venous leak at the level of the scar due to incomplete distension of the erectile tissue presenting with high-velocity venous flows low flow priapism; rarely it can follow high-flow priapism as well [31,37]. During erection the fibrotic plaques may cause penile bending and the involved sinusoids cannot distend causing veno-occlusive dysfunction [4,38].…”

Section: Postraumatic Scarring and Fibrosismentioning

confidence: 98%

Imaging of penile traumas—therapeutic implications

2005

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Injury to the penis may result from penetrating or nonpenetrating trauma. Nonpenetrating injury to the erect penis can produce albugineal tear, intracavernous hematoma or extraalbugineal hematoma from rupture of the dorsal vessels. Nonpenetrating injury to the flaccid penis usually follows blunt perineal traumas producing extratunical or cavernosal haematomas, or cavernosal artery tear followed by high flow priapism. Differential diagnosis between albugineal tear and other penile injuries must be obtained as soon as possible, since early surgical repair of albugineal tear reduces significantly the rate of postraumatic curvature and fibrosis. Ultrasonography (US) is able to detect the exact site of the tear in most patients as an interruption of the thin echogenic line of the tunica albuginea. Other imaging techniques are rarely required in the clinical practice. Color Doppler US is the imaging modality of choice to evaluate patients with high flow priapism. Focal or diffuse cavernosal fibrosis can be identified with US as echogenic areas in the cavernosal bodies. Postraumatic erectile dysfunction can result from fibrotic changes, nerve and vascular impairment or both. Doppler evaluation of penile vasculature is required in young patients with postraumatic impotence before surgical revascularization procedures.

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Color Doppler appearance of penile cavernosal–spongiosal communications in patients with severe Peyronie's disease

Cited by 19 publications

References 18 publications

Vasculogenic impotence as a symptom in late‐onset Buerger's disease

Vasculogenic impotence as a symptom in late‐onset Buerger's disease

A Sign of Arteriogenic Insufficiency on Penile Doppler Sonography

Imaging of penile traumas—therapeutic implications

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