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Duplex Doppler sonography of the flaccid penis: Potential role in the evaluation of impotence
Author(s) -
Roy Catherine,
Saussine Christian,
Tuchmann Christine,
Castel Elisabeth,
Lang Hervé,
Jacqmin Didier
Publication year - 2000
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/1097-0096(200007/08)28:6<290::aid-jcu4>3.0.co;2-y
Subject(s) - medicine , arterial insufficiency , cutoff , intracavernous injection , ultrasonography doppler , penis , erectile dysfunction , duplex ultrasonography , prostaglandin e1 , radiology , duplex (building) , ultrasound , doppler sonography , nuclear medicine , surgery , cardiology , vascular disease , ultrasonography , dna , physics , genetics , quantum mechanics , biology
Purpose Duplex Doppler sonography of the cavernosal arteries of the penis with intracavernous injection (ICI) of vasoactive agents has been widely used to evaluate arterial insufficiency in impotence. Our goal was to assess the potential value of peak systolic velocity (PSV) measurements on the flaccid penis in the diagnosis of arteriogenic impotence. Methods Forty‐four men underwent duplex Doppler sonography with PSV measurements before and after ICI of prostaglandin E 1 . Three different cutoff values for lowest normal PSV before injection—5 cm/second, 10 cm/second, and 15 cm/second—were tested. Results Thirteen patients had arteriogenic insufficiency based on post‐ICI duplex sonography and clinical response. Results for our different cutoff PSV values of 5 cm/second, 10 cm/second, and 15 cm/second in diagnosing arteriogenic impotence were, respectively: sensitivity 29%, 96%, and 100%; specificity 100%, 92%, and 23%; negative predictive value 80%, 92%, and 100%; positive predictive value 100%, 81%, and 41%; and overall accuracy 79%, 93%, and 44%. In the flaccid state, there was a significant difference in mean PSV between the “normal” group (12.6 ± 0.9 cm/second) and the arteriogenic impotence group (7.7 ± 1.1 cm/second). Twenty‐nine patients with a bilateral PSV of 10 cm/second or less before ICI had a normal clinical response. Conclusions A cutoff PSV value of 10 cm/second in the flaccid state had the best accuracy in predicting arterial insufficiency. Duplex Doppler sonography is proposed as the initial test to evaluate the penile arterial supply and to determine whether patients are good candidates for therapy with ICI. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:290–294, 2000.