Doppler ultrasound and cavernosography evaluation in infertile man with non-erection

ABSTRACT

Examination of the penile artery by duplex scanning in the assessment of impotence was evaluated in 140 impotent men. Scanning was done by Technicare, Diasonic DRF400, and penile artery measurements were taken before and after intracorporeal injection of papaverine hydrochloride 60 mg. The penile brachial index was measured in 80 patients and its predictive value compared with the results of duplex scanning and papaverine induced erection. On scanning evidence of good arterial inflow but poor erections, indirect evidence of venous leakage was assumed. The results showed that the deep artery responses best characterized the erectile response, with the dorsal artery being less helpful. All 30 patients with full erections following papaverine exhibited deep artery peak velocities of <25 cm/s, of the remaining 110 sub-optimal responsers, 20 also had this finding, all had undergone dynamic cavernosography, with 19 exhibited venous leakage. A critical value of deep artery response to attain erection is postulated, enabling more logical use of cavernosography. The penile/brachial index was shown to be suspected, and it was concluded that duplex scanning is a useful, noninvasive method in the assessment of impotence