Duplex ultrasound evaluation of cavernosal peak systolic velocity and waveform acceleration in the penile flaccid state: clinical significance in the assessment of the arterial supply in patients with erectile dysfunction

Abstract

The aim of this paper was to establish if duplex ultrasound parameters obtained for assessment of the patency of cavernosal arteries in the penile flaccid state can give sufficient clinical information without the use of intracavernosal injection of vasodilatory drugs. We assessed mean cavernosal peak systolic velocity (PSV) in the penile flaccid state (basal PSV), and after PGE1 injection (dynamic PSV) in 339 unselected patients with erectile dysfunction. In 55 of these patients the waveform acceleration in the flaccid state was also assessed. The results of the study can be summarized as follows: (1) a significant relationship was found between basal and dynamic PSV in the 339 patients (r=0.477; p < 0.0001); (2) a basal PSV >12.5 cm/sec was predictive of a dynamic PSV >/=30 cm/sec in 129/139 (92.8%) of the patients, whereas in patients with a basal PSV </=12.5 a dynamic PSV both > or <30 cm/sec could be found; and (3) an acceleration >1 m/sec2 in the flaccid state was coupled to a dynamic PSV >30 cm/sec in 43/46 (93.5%) of the patients independent of the basal PSV. In conclusion, these results suggest that the combined duplex ultrasound assessment of PSV and waveform acceleration in the penile flaccid state can predict arterial dynamic inflow in the majority (51/55; 92.7%) of patients with erectile dysfunction, with less time and expense and less discomfort for the patient.

Structured interview on erectile dysfunction (SIEDY©): a new, multidimensional instrument for quantification of pathogenetic issues on erectile dysfunction

“…A PGE 1 -induced cavernosal peak systolic velocity (PSV) Z30 cm/s was considered normal. 20,21 In selected patients with a possible neurogenic component of ED, neurophysiologic tests were performed (assessment of the sacral reflex, somatosensory-evoked potential of the pudendal nerve, skin reflex, anal or urethral sphincter electromyogram). 22 An organic component (OC) of ED was considered present when at least one of the following conditions was satisfied: Scores of the previously identified scales of the interview were correlated with demographic and clinical parameters using Spearman's method.…”

Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction

“…The following parameters were considered: basal peak systolic velocity and acceleration, peak systolic velocity and end diastolic velocity after PGE 1 intracavernous injection (10 mg), and resistance index. 16 Data were expressed as mean7s.d. when normally distributed, and as median (quartiles) for parameters with non-normal distribution.…”

Difficulties in achieving vs maintaining erection: organic, psychogenic and relational determinants

“…The following parameters were considered: basal peak systolic velocity and acceleration, peak systolic velocity (VPS max ) and end diastolic velocity after PGE 1 intracavernous injection, resistance index. 15,16 A VPS max lower than 30 cm/s was considered pathological as previously described. 15,16 For comparison a consecutive series of 40 patients referring to out andrologic clinic for sexual dysfunction was studied; these patients aged 47.0714.1 y, with a BMI of 25.573.3 kg/m 2 , were complained RE (48.2%), HSD (34.9%), or other (16.9%).…”