Color Doppler appearance of penile cavernosal–spongiosal communications in patients with normal and impaired erection

Abstract

Our objective was to investigate prevalence and Doppler characteristics of penile cavernosal-spongiosal communications (CSC). These vessels are either anastomoses connecting the cavernosal arteries with the urethral arterial network or afferent vessels to the corpus spongiosum. Sixty-one consecutive patients underwent penile color Doppler US. Waveform changes in CSC were evaluated in comparison with changes in the cavernosal artery. Eighteen of 61 patients had normal erection, 17 of 61 had arterial insufficiency, and 26 of 61 had veno-occlusive dysfunction. Resistance index (RI) in CSC was significantly lower than in cavernosal arteries in all patients and increased during phases 1-2 (positive diastolic flow). Peak systolic velocity (PSV) in CSC was significantly higher in the patients with veno-occlusive dysfunction. During cavernosal phase 4 (diastolic flow reversal) CSC of patients with normal erection or with arterial insufficiency disappeared, underwent markedly reduced diastolic flow, or had systolic flow inversion. Conversely, low resistance flow was appreciable in CSC of patients with veno-occlusive dysfunction who reached phase 4. During phase 5 (systolic peak reduction) all CSC disappeared. Color Doppler US allows evaluation of CSC both in patients with normal and impaired erection.

A Sign of Arteriogenic Insufficiency on Penile Doppler Sonography

“…6 A CSC was defined as the presence of a straight vessel arising from the cavernosal artery, crossing the corpus cavernosum toward its ventral aspect, passing through the tunica albuginea, and entering the corpus spongiosum. 7 All patients were evaluated for flow direction in the CSCs. The overall examination time was about 30 minutes.…”

Color Doppler imaging of erectile dysfunction: a new place in strategy?

“…In the present issue a paper from Bertolotto et al [1] describes the anatomical and functional patterns of arterial cavernosal-spongiosal communications shown by color flow Doppler sonography. These normal vessels, probably playing no role in veno-occlusive dysfunction, have been described by anatomists and could explain, with their satellite veins, the diffusion of agents infused intra-urethrally within corpus spongiosum; however, their exact function remains unclear.…”

“…The paper by Bertolotto et al [1] illustrates the ability of up-to-date high-quality ultrasound systems to better demonstrate, with high-frequency probes providing a higher spatial resolution and a higher sensitivity to slow flow, the vascular anatomy of the penis. With older systems, mainly central cavernous arteries, dorsal arteries and some helicine arteries were visible.…”

Resumen de la Guía de Práctica Clínica de Disfunción Eréctil – Sociedad Colombiana de Urología

“…Igualmente contamos con la Angiografía por TAC multicorte con reconstrucción en 3D, que permite la definición completa de las arterias cavernosas y pudendas en ese tipo de pacientes. [74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90] Tratamiento El objetivo de la terapia debe ser restaurar la satisfacción de la vida sexual y no solo la erección rígida.…”