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Evaluation of Vasculogenic Erectile Impotence using Penile Duplex Ultrasonography

1989; Lippincott Williams & Wilkins; Volume: 142; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(17)39128-0

1527-3792

Ridwan Shabsigh, Irving J. Fishman, Emilio T. Quesada, Carie Seale-Hawkins, J. Kay Dunn,

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No AccessJournal of Urology1 Dec 1989Evaluation of Vasculogenic Erectile Impotence using Penile Duplex Ultrasonography Ridwan Shabsigh, Irving J. Fishman, Emilio T. Quesada, Carie K. Seale-Hawkins, and J. Kay Dunn Ridwan ShabsighRidwan Shabsigh , Irving J. FishmanIrving J. Fishman , Emilio T. QuesadaEmilio T. Quesada , Carie K. Seale-HawkinsCarie K. Seale-Hawkins , and J. Kay DunnJ. Kay Dunn View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)39128-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail A total of 140 patients underwent penile vascular evaluation with intracavernous papaverine injection combined with duplex ultrasonography. Of these patients 8 were potent men who were evaluated for reasons other than erectile failure. These potent men were used as controls to obtain normal values. The remaining 132 patients had erectile impotence of various etiologies. Real-time imaging with high resolution, high frequency probes allowed for visualization of the cavernous arteries along the entire length in addition to accurate measurement of the diameter. Simultaneous selectively focused Doppler ultrasonography was used to measure the blood velocity and other vascular parameters in the cavernous and dorsal arteries. Comparison of measurements before and after papaverine injection allowed for objective interpretation of the injection results. The results were analyzed and compared to other data available on the same patients, such as history and physical examination, nocturnal penile tumescence, penile blood pressures, selective arteriography and dynamic cavernosography. In addition to the 8 potent men, there were 35 patients (27% of the impotent patients) whose vascular findings were normal. A total of 78 patients (59% of the impotent patients) had arterial insufficiency; a subgroup of 13 patients had the pelvic arterial steal syndrome. Dynamic cavernosography confirmed venous leak in all 19 patients (14% of the impotent patients) whose penile duplex ultrasonography suggested the possibility of a venous leak. Ten patients (7%) had prolonged erection after papaverine injection and they were managed without consequences. One patient had a small hematoma that resolved uneventfully. Penile duplex ultrasonography was a helpful and objective method to evaluate vasculogenic impotence. © 1989 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byKoraitim M (2014) Predicting Risk of Erectile Dysfunction after Pelvic Fracture Urethral Injury in ChildrenJournal of Urology, VOL. 192, NO. 2, (519-523), Online publication date: 1-Aug-2014.TAM P, KELLER T, POPPITI R, GESUNDHEIT N and PADMA-NATHAN H (2018) HEMODYNAMIC EFFECTS OF TRANSURETHRAL ALPROSTADIL MEASURED BY COLOR DUPLEX ULTRASONOGRAPHY IN MEN WITH ERECTILE DYSFUNCTIONJournal of Urology, VOL. 160, NO. 4, (1321-1324), Online publication date: 1-Oct-1998.DE MEYER J and THIBO P (2018) THE CORRELATION AMONG CAVERNOUS PRESSURE, PENILE RIGIDITY AND RESISTANCE INDEXJournal of Urology, VOL. 160, NO. 1, (63-66), Online publication date: 1-Jul-1998.Levine L and Coogan C (2018) Penile Vascular Assessment Using Color Duplex Sonography in Men with Peyronie's DiseaseJournal of Urology, VOL. 155, NO. 4, (1270-1273), Online publication date: 1-Apr-1996.Dean Knoll L, Benson R, Bilhartz D, Minich P and Furlow W (2018) A Randomized Crossover Study Using Yohimbine and Isoxsuprine Versus Pentoxifylline in the Management of Vasculogenic ImpotenceJournal of Urology, VOL. 155, NO. 1, (144-146), Online publication date: 1-Jan-1996.Rhee E, Osborn A and Witt M (2018) The Correlation of Cavernous Systolic Occlusion Pressure With Peak Velocity Flow Using Color Duplex Doppler UltrasoundJournal of Urology, VOL. 153, NO. 2, (358-360), Online publication date: 1-Feb-1995.Iacono F, Barra S and Lotti T (2018) Evaluation of Penile Deep Arteries in Psychogenic Impotence by Means of Duplex UltrasonographyJournal of Urology, VOL. 149, NO. 5 Part 2, (1262-1264), Online publication date: 1-May-1993.Wespes E and Schulman C (2018) Venous Impotence: Pathophysiology, Diagnosis and TreatmentJournal of Urology, VOL. 149, NO. 5 Part 2, (1238-1245), Online publication date: 1-May-1993.Wespes E, De Goes P and Schulman C (2018) Vascular Impotence: Focal or Diffuse Penile DiseaseJournal of Urology, VOL. 148, NO. 5 Part 1, (1435-1436), Online publication date: 1-Nov-1992.Kropman R, Schipper J, Oostayen J, Lycklama À Nijeholt A and Meinhardt W (2018) The Value of Increased End Diastolic Velocity during Penile Duplex Sonography in Relation to Pathological venous Leakage in Erectile DysfunctionJournal of Urology, VOL. 148, NO. 2 Part 1, (314-317), Online publication date: 1-Aug-1992.Meuleman E, Bemelmans B, Doesburg W, van Asten W, Skotnicki S and Debruyne F (2018) Penile Pharmacological Duplex Ultrasonography: A Dose-Effect Study Comparing Papaverine, Papaverine/Phentolamine and Prostaglandin E1Journal of Urology, VOL. 148, NO. 1, (63-66), Online publication date: 1-Jul-1992.Meuleman E, Bemelmans B, van Asten W, Doesburg W, Skotnicki S and Debruyne F (2018) Assessment of Penile Blood Flow by Duplex Ultrasonography in 44 Men with Normal Erectile Potency in different Phases of ErectionJournal of Urology, VOL. 147, NO. 1, (51-56), Online publication date: 1-Jan-1992.Shabsigh R, Fishman I, Toombs B and Skolkin M (2018) Venous Leaks: Anatomical and Physiological ObservationsJournal of Urology, VOL. 146, NO. 5, (1260-1265), Online publication date: 1-Nov-1991.Dalkin B and Carter M (2018) Venogenic Impotence Following Dermal Graft Repair for Peyronie’s DiseaseJournal of Urology, VOL. 146, NO. 3, (849-851), Online publication date: 1-Sep-1991.Hwang T, Liu P and Yang C (2018) Evaluation of Penile Dorsal Arteries and Deep Arteries in Arteriogenic ImpotenceJournal of Urology, VOL. 146, NO. 1, (46-49), Online publication date: 1-Jul-1991.Floth A and Schramek P (2018) Intracavernous Injection of Prostagland in E1 in combination With Papaverine: Enhanced Effectiveness in Comparison With Papaverine Plus Phentolamine and Prostaglandin E1 AloneJournal of Urology, VOL. 145, NO. 1, (56-59), Online publication date: 1-Jan-1991.Shabsigh R, Fishman I, Shotland Y, karacan I and Dunn J (2018) Comparison of Penile Duplex Ultrasonography with Nocturnal Penile Tumescence Monitoring for the Evaluation of Erectile ImpotenceJournal of Urology, VOL. 143, NO. 5, (924-927), Online publication date: 1-May-1990. Volume 142Issue 6December 1989Page: 1469-1474 Advertisement Copyright & Permissions© 1989 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Ridwan Shabsigh More articles by this author Irving J. Fishman More articles by this author Emilio T. Quesada More articles by this author Carie K. Seale-Hawkins More articles by this author J. Kay Dunn More articles by this author Expand All Advertisement PDF downloadLoading ...