Faculty Collaboration Database

Color Doppler sonography in the evaluation of erectile dysfunction: patterns of temporal response to papaverine. AJR Am J Roentgenol 1991 Aug;157(2):331-6

Date

08/01/1991

Pubmed ID

1853817

DOI

10.2214/ajr.157.2.1853817

Scopus ID

2-s2.0-0025834910 (requires institutional sign-in at Scopus site)   46 Citations

Abstract

Most studies of duplex Doppler sonography for the assessment of erectile dysfunction involve determination of peak systolic velocities 5 min after intracavernosal injection of papaverine. The purpose of this study was to determine the effect of the timing of Doppler measurements of flow after papaverine injection for establishing the presence of arterial and venous abnormalities. Color Doppler sonography was performed in 75 patients for evaluation of vasculogenic impotence. After intracavernosal injection of 60 mg of papaverine, measurements of peak systolic and end-diastolic velocities were obtained in each cavernosal artery at 5-min intervals for a total of 30 min. A peak systolic velocity of less than 25 cm/sec was used as the threshold for arterial insufficiency. An end-diastolic velocity of greater than 5 cm/sec was used to predict venous incompetence. Scanning was performed for direct assessment of dorsal venous flow. Thirty patients were subsequently evaluated by cavernosometry and cavernosography. In most patients (76%), maximum response to papaverine was achieved within the first 5 min. In eight patients, significant increases in systolic velocity were seen only after 5 min. In 10 patients, significant changes in end-diastolic velocity between 5 and 30 min resulted in diagnostic reclassification. Data acquisition for 30 min significantly improved the sensitivity (95%) and specificity (83%) for the prediction of venous incompetence in patients with correlative cavernosography. Transient, early dorsal vein flow was noted in normal subjects. Persistent dorsal vein flow had an 80% sensitivity and 100% specificity for venous incompetence. Our results suggest that, when using color Doppler sonography, gathering data for 30 min may improve the prediction of vasculogenic impotence.

Author List

Fitzgerald SW, Erickson SJ, Foley WD, Lipchik EO, Lawson TL

Author

Scott J. Erickson MD Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Blood Flow Velocity
Erectile Dysfunction
Humans
Male
Middle Aged
Papaverine
Penile Erection
Penis
Ultrasonography
Vascular Diseases