Evaluation of impotent male by doppler ultrasound and cavernosography

ABSTRACT

Examination of the penile artery by duplex scanning in the assessement of impotence was evaluated in 140 impotent men. Scanning was by Technicare, Diasonic DRF400, and penile artery measurements were taken before and after intra-corporeal injection of papaverin hydrochloride 60 mg. The penile brachial index was measured in 80 patients and its predictive value compared with the resuls of duplex scanning and papaverine induced erection. On scanning evidence of good arterial in flow but poor erections, indirect evidence of venous leakage was assumed. The results showed that the deep artery responses best characterised the erectile response, with the dorsal artery being less helpful. All 30 patients with full erections following papavrine exhibited bilateral deep artery peak Velocities of > 25 cm/s, of the remaining 110 sub-optimal responders, 20 also has this finding; all had undergone dynamic cavernosograpliy, with 19 exhibited venous leakae. A critical value of deep artery response to attain erection is postulated, enabling more logical use of cavernosogrpahy. The penile/brachial index was shown to be suspected and it was concluded that duplex scanning is a useful, non-invasive method in the assessment of imptence