Colour and spectral doppler sonography in the diagnosis of vascular impotence

During a 10 month period, 45 patients [age range 17-72 years] with impotence were examined Linear transducers 5 and 7.5 MHz [Acuson 128 and ATL] were used to measure peaksystolic velocity [PSV] and end diastolic velocity [EDV] of the cavernosal arteries bilaterally as well as the deep dorsal vein. Measurements were made between 5 minutes and one hour after the intracorporeal injection of prostaglandin EL [alprostadil]Twenty-seven patients [60%] developed grades 4 and 5 erections and were observed to have PSV> 27 cm/sec and ED V <6 cm/sec. Eighteen patients [40%] had poor erections [grades 1-3] with PSV <21 cm/sec, EDV> 6cm/sec and with a velocity of> 8 cm/sec in the deep dorsal vien three patterns of vascular impotence were observed: arterial insufficiency, venous leakage and mixed type in which there were both arterial and venous inadequacies. Colour Doppler permitted localisation of the vessels for spectral Doppler analysis