Duplex Doppler ultrasonography: Noninvasive assessment of penile anatomy and function

Broderick, Gregory A.; Arger, Peter H.

doi:10.1016/s0037-198x(05)80112-9

Cited by 79 publications

(46 citation statements)

References 53 publications

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“…Assessment of penile arterial system with CDU has a sensivity of 100% and speci®city of 95% when compared to pudendal arteriography. 16,17 Although dynamic infusion cavernosometry and cavernosography (DICC) is supposed to be the gold standard for detection of VOD, an EDV of b 5 cmasec measured after ICI of vasoactive agent by CDU, yielded a speci®city of 56% and sensitivity of 90% for detection of venous leakage when compared with DICC. 16,17 Similarly, resistance index (RI)`75% by CDU is associated with venous leakage in 95% patients when compared with DICC.…”

Section: Introductionmentioning

confidence: 99%

“…16,17 Although dynamic infusion cavernosometry and cavernosography (DICC) is supposed to be the gold standard for detection of VOD, an EDV of b 5 cmasec measured after ICI of vasoactive agent by CDU, yielded a speci®city of 56% and sensitivity of 90% for detection of venous leakage when compared with DICC. 16,17 Similarly, resistance index (RI)`75% by CDU is associated with venous leakage in 95% patients when compared with DICC. 16,17 The subject of this study is to categorize Peyronie's patients according to their erectile status by history and de®ne the penile vascular abnormalities assessed by CDU among Peyronie's patients with or without ED.…”

Section: Introductionmentioning

confidence: 99%

“…16,17 Similarly, resistance index (RI)`75% by CDU is associated with venous leakage in 95% patients when compared with DICC. 16,17 The subject of this study is to categorize Peyronie's patients according to their erectile status by history and de®ne the penile vascular abnormalities assessed by CDU among Peyronie's patients with or without ED.…”

Section: Introductionmentioning

confidence: 99%

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Color Doppler ultrasound assessment of penile vascular system in men with Peyronie's disease

et al. 2000

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The purpose of this study was to evaluate the penile vascular function by color Doppler ultrasonography (CDU) in patients with Peyronie's disease. A total of 136 men with Peyronie's disease were strati®ed according to their potency by history as Group I consisting of potent patients and Group II consisting of patients with erectile dysfunction. They were all evaluated by penile CDU.Overall, 70.6% had erectile dysfunction by history. CDU revealed penile vascular abnormalities in 76.5%. In Group I, veno-occlusive dysfunction (VOD) was observed in 40% while mixed (arterial venous) vascular disease was diagnosed in 10%. Penile vascular disease was detected in 87.5% patients in Group II (ie VOD in 28%, arterial disease in 9.3% and mixed vascular disease in 50%). The prevalence of arterial disease on CDU among Peyronie' patients with erectile dysfunction (59.3%) was signi®cantly (P`0.05) higher then it was among potent patients (10%). The prevalence of pure VOD was almost similar for patients with or without erectile dysfunction (P`0.05).We conclude that penile vascular abnormalities can be observed in 76.5% on cases with Peyronie's disease by CDU and this ratio signi®cantly increases to 87.5% among cases with erectile dysfunction by history. Our data also indicate that arterial disease, accounts for much of the diminished rigidity in men with Peyronie's disease.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Color Doppler ultrasound assessment of penile vascular system in men with Peyronie's disease

et al. 2000

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“…Vascular assessment was performed following PGE1 injection both before and after privacy and self-stimulation, measuring peak systolic velocity (PSV) and resistive index (RI) of the dorsal cavernosal arteries. 3,4 Patients aged 60 y or younger were given 6 mcg of PGE1 and patients older than 60 y were given 10 mcg. All patients were then studied by color duplex Doppler using a 7.5 MHz linear transducer with standoff wedge to maximize near-®eld imaging (Siemens Quantum, Issaquah, WA).…”

Section: Methodsmentioning

confidence: 99%

Diabetes and vascular impotence: does insulin dependence increase the relative severity?

Broderick

1999

Int J Impot Res

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Aim of the study: Diabetes is a well documented risk factor for vascular erectile dysfunction (ED). We evaluated the relative roles of insulin dependence (IDDM) vs oral agent controlled diabetes (NIDDM) in predicting the etiologies and severity of ED: arterial insuf®ciency (AI), venous leakage (CVOD), and mixed vascular disease. The impact of additional risk factors were also analyzed: hypertension (HTN), coronary artery disease (CAD), and smoking (SM). Methods: Retrospective data on 105 patients complaining of impotence who underwent pharmacotesting with PGE1 (Caverject) and color duplex Doppler was reviewed. Penile blood ow study (PBFS) data following a period of privacy and self-stimulation was compared. PBFS diagnostic criteria were: AI for peak systolic velocity (PSV)<25 cmas; CVOD for PSV!35 cmas and resistive index (RI)<0.9; mixed vascular disease for PSV!25 cmas, PSV<35 cmas and RI>0.9. Consistent dosing of PGE1 was used; 6 mcg for age<60 y and 10 mcg for age !60 y. Patients were NIDDM (79 out of 105) and IDDM (26 out of 105). Mean ages for NIDDM and IDDM were respectively 60, and 55 y. The relative signi®cance of insulin dependence was assessed by Student's t-test. Results: The most common etiology of ED was arterial insuf®ciency: mean PSV's did not signi®cantly vary and were: 23.5 cmas for NIDDM, and 21.6 cmas for IDDM. PBFS parameters did not vary signi®cantly for the risk factors of SM or HTN and diabetes. Mean peak systolic velocities were signi®cantly different among diabetics with coronary artery disease: NIDDMaCAD, 22.9 cmas compared to IDDMaCAD, 14.8 cmas (P 0.006). Conclusions: We found among the 105 diabetics the most common etiology of vascular ED based on Doppler criteria was arterial insuf®ciency, 64%. Statistical analysis of additional risk factors (SM, HTN, CAD) suggested that patients with IDDM and CAD have more severe cavernosal arterial insuf®ciency than patients with NIDDM and CAD. This data tends to support the theory that microangiopathy is the predominant factor in diabetic impotence, and that insulin dependent diabetes with`large vessel' coronary heart disease have a similar pathology in the`small vessels' regulating penile in¯ow which is unfortunately worse than their non-insulin dependent counterparts.

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“…While most centers are currently using duplex Doppler penile ultrasonography. [1][2][3][4] as their vascular evaluation of choice, the previously widely used study, dynamic infusion cavernosometry (DIC), is still used by some centers, [5][6][7][8][9][10] including ours.…”

Section: Introductionmentioning

confidence: 99%

Congruence between veno-occlusive parameters during dynamic infusion cavernosometry: assessing the need for cavernosography

2004

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While dynamic infusion cavernosometry (DIC) is being performed with increasing rarity, some centers continue to use this investigation modality. Cavernosography may be utilized to identify the location of patent venous channels in men with venous leak. In an era when venous ligation surgery is being performed with less frequency, the role of cavernosography has been questioned. This study was conducted to define the congruence between the three parameters (flow-to-maintain (FTM), pressure decay (PD) and cavernosography) used in the diagnosis of venous leak during DIC. Established values for the three parameters were utilized and the diagnosis of venous leak was based upon the FTM measurement. All studies were performed using a vasoactive agent-redosing schedule. Cavernosography was conducted using a nonionic contrast agent at an intracorporal pressure of 90 mmHg. In patients with an elevated FTM value, 24% had a normal PD recorded, all of whom had FTM values o10 ml/min. The Pearson correlation coefficient for the relationship between FTM and PD was 0.58 (P ¼ 0.025). In all, 36 patients (54%) had an abnormal cavernosogram (CG). All patients who had positive findings on CG had elevated FTM values. On the other hand, 46% of patients with abnormal FTM values had a normal CG. This analysis indicates that almost one-half of men with venous leak diagnosed at the time of DIC based on FTM measurement will fail to have any veins visualized on cavernosography. These data further undermine the value of cavernosography, particularly in men with low-grade venous leak.

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Duplex Doppler ultrasonography: Noninvasive assessment of penile anatomy and function

Cited by 79 publications

References 53 publications

Color Doppler ultrasound assessment of penile vascular system in men with Peyronie's disease

Color Doppler ultrasound assessment of penile vascular system in men with Peyronie's disease

Diabetes and vascular impotence: does insulin dependence increase the relative severity?

Congruence between veno-occlusive parameters during dynamic infusion cavernosometry: assessing the need for cavernosography

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