Failure to attain stretched penile length after intracavernosal injection of a vasodilator agent is predictive of veno‐occlusive dysfunction on penile duplex Doppler ultrasonography

• Published in: Andrology (Oxford) 2015-09, Vol.3 (5), p.919-923
• Main Authors: Yafi, F. A., Libby, R. P., McCaslin, I. R., Sangkum, P., Sikka, S. C., Hellstrom, W. J. G.
• Format: Article
• Language: English
• Subjects: Alprostadil - therapeutic use; Arterial Occlusive Diseases - diagnosis; Arterial Occlusive Diseases - diagnostic imaging; erectile dysfunction; Humans; Impotence, Vasculogenic - diagnosis; Impotence, Vasculogenic - diagnostic imaging; Impotence, Vasculogenic - drug therapy; Impotence, Vasculogenic - physiopathology; Male; Middle Aged; penile duplex Doppler ultrasound; Penile Erection - drug effects; Penis - blood supply; Penis - diagnostic imaging; Penis - pathology; Peyronie's disease; Retrospective Studies; stretched penile length; Ultrasonography, Doppler, Duplex; Vasodilator Agents - therapeutic use; veno‐occlusive dysfunction
• ISSN: 2047-2919; 2047-2927
• DOI: 10.1111/andr.12073

Summary Penile duplex Doppler ultrasound (PDDU) assesses the etiology of erectile dysfunction. Peak systolic velocity (PSV), end‐diastolic velocity (EDV), and resistive index (RI) are common PDDU parameters. We assessed whether stretched penile length (SPL) in the flaccid state and measured penile length at peak erection after intracavernosal injection (ICI) of a vasodilator during PDDU correlated with the etiology of erectile dysfunction. We performed a retrospective review of 93 patients who underwent PDDU for erectile dysfunction. Normal and stretched penile length were measured, both at a flaccid state prior to ICI and at peak erection during PDDU. Collected data included patient demographics, vascular, and anatomic parameters. The mean age was 52 years. SPL was equivalent to peak penile length after ICI in 60 patients (65%, group 1) and did not match in 33 (35%, group 2). There were no significant differences between the two groups in terms of flaccid, stretched, and post‐ICI erect penile lengths, IIEF score, PSV, percent rigidity or tumescence, and vasodilator dose used. Patients in group 2 had less of a change in penile length from flaccid to erect state (36% vs. 44%, p = 0.02), higher EDV (12.0 vs. 8.5, p = 0.041), lower RI (0.6 vs. 1.0, p = 0.046), and more veno‐occlusive dysfunction (82% vs. 53%, p = 0.001). On multivariate analysis, failure to reach maximum SPL at peak ICI erection (OR 2.255, CI 1.191–4.271, p = 0.0126), EDV (OR 1.281, CI 1.115–1.471, p