Diagnostic Value of Duplex Ultrasound for the Evalution of Corporal Veno-occlusive Function in Penile Erection / 대한비뇨기과학회지

Corporal veno-occlusive function is the essential part in the hemodynamic process of penile erection. Parameters for evaluation of the quality of the veno-occlusive mechanism are end diastolic flow velocity (EDV) and its derivative resistance index (RI) as measured by pharmacopenile duplex ultrasound which is considered as an initial screening test for the patients with vasculogenic impotence. We compared the accuracy of these parameters by investigating the correlation between the result of duplex sonographic study and some other studies, pharmacoerection test and dynamic infusion cavernosometry (DIC) in 45 patients who received all of these studies and were proved to have normal arterial inflow of the penis. EDV and RI values were well correlated with maintenance flow rate values of DIC at various levels of intracavernosal pressures (50, 100 and 150 mmHg) (R=0.418-0.701 and R=0.454-0.620 respectively). Diagnostic result of duplex scanning was identical to cavernosometric result in 80% and pharmacoerection response in 82%. We conclude that EDV and RI appeared to be used as good indices evaluating corporal veno-occlusive function.

A comparative study on various methods of cavernosometry as predictors of corporal-venous leakage demonstrated by cavernosography / 대한비뇨기과학회지

A variety of technique of dynamic pharmacocavernosometry have been described to evaluate cavernous veno-occlusive function: however, there is no uniquely reliable and standard method so far After intracavernous (IC) injection of 45 mg papaverine and 2.5 mg phenblamine, we performed gravity cavernosometry(GC) and pump cavernosometry(PC), ie, measurement of saline infusion rate needed to obtain and to maintain an erection and measurement of pressure decay for 30 seconds and pressure drop time to 75 mmHg when pump was turned off at 150 mmHg IC pressure. Final diagnosis of venous leakage was made by cavernosoeraphy done at 90 mmHg IC pressure. The parametric values measured by each method to diagnose venous leakage and correlation among these methods were analyzed. The etiology of impotence in 45 patients studied was psychogenic in 8, venogenic in 21, combined arteriogenic and venogenic in 16. The measurement of induction flow rate was less reliable(p<0.05) for the diagnosis of venous leak than the other methods of PC and GC (p<0.01). The standard deviations of the induction and maintenance flow rate and pressure drop time were similar to or even higher than mean values. There was correlation among all these methods. Therefore, GC and PC, particularly measurement of the intracorporeal pressure decay are believed to be valuable methods for diagnosis of the corporal-venous leakage.