ABSTRACT
Doppler wave length analysis was used to assess penile blood flow in 50 important patients both in the flaccid state and after induction of erection with 25 ug/ml prostaglandin E1, intracavernous injection. Nine volunteers served as controls. Maximum velocity was slightly lower in patients in the flaccid state but was not different from controls after induction of erection. Prostaglandin E1, induced good erection which lasted for an average of 2.6 hours in 100% of controls and 80% of patients. In 9 patients whose main complain was rapid loss and weakness of erection, the end diastolic velocity was above the zero base line, after prostaglandin injection they developed tumescence without rigidity and the end diastolic velocity increased to more then 5 cm/sec. Cavernosography proved venous leak in 8 of those patients [88.8%]. There was a good correlation between a normal Doppler analysis and a positive response to prostaglandin injection. Elevated end diastolic velocity especially after prostaglandin was predictive of venous leak. No complications resulted from the use of prostaglandin E1 injections. The combined use of Doppler and prostaglandin E1 intracavernous injection enhanced the diagnostic yield of both of them and allowed selection of candidates for cavernosography