Abstract
The discovery that penile erection is a vascular phenomenon the quality of which is adversely affected by identifiable clinical factors coincided with the advent of multiple technologies for penile imaging. The 1980s and 1990s saw the development of many penile diagnostics; of these technologies, color duplex Doppler ultrasound is the least invasive and most informative. Before the wide availability of Doppler technology, a vasoactive penile injection administered in the office permitted the physician to roughly distinguish between severe arterial disease and psychogenic erectile dysfunction (ED). Whether the agent is papaverine, prostaglandin E1, or a combination of vasoactive medications, the addition of duplex Doppler ultrasound provides greater objective criteria for evaluating penile responses.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Blander DS, Sanchez-Ortiz RF, Broderick GA: Sex questionnaires: can they replace etiology specific testing? Urology 1999, 54: 719–723.
Aboseif SR, Lue TF. Hemodynamics of penile erection. Urol Clin N Am 1988, 15: 1–7.
Andersson K-E, Wagner G: Physiology of penile erection. Physiol Rev 1995, 75: 191–236.
Sanchez-Ortiz R, Broderick GA: Vascular Evaluation of ED. In Male Sexual Function: A Guide to Clinical Management. Edited by Mulcahy JJ. Totowa, NJ: Humana Press; 2001: 167–199.
Virag R, Frydman D, Legman M, Virag H: Intracavernous injection of papaverine as a diagnostic and therapeutic method in erectile failure. Angiology 1984, 35: 79–87.
Pescatori ED, Hatzichristou DG, Namburi S, Goldstein I: A positive intracavernous injection test implies normal veno-occlusive but not necessarily normal arterial function: a hemodynamic study. J Urol 1994, 151: 1209–1216.
Cormio L, Nisen H, Selvaggi FP, Ruutu M: A positive pharmacological erection test does not rule out arteriogenic erectile dysfunction. J Urol 1996, 156: 1628–1630.
Elhanbly S, Schoor R, Elmogy M, et al What nonresponse to intracavernous injection really indicates: a determination by quantitative analysis. J Urol 2002, 167:192–196.
Aversa A, Isidori AM, Caprio M, et al.: Penile pharmacotesting in diagnosing male erectile dysfunction: evidence for lack of accuracy and specificity. Int J Androl 2002, 25: 6–10.
Curet P, Grellet J, Perrin D, et al.: Technical and anatomic factors in filling of distal portion of internal pudendal artery during arteriography. Urology 1987, 29:333–338.
Bahren W, Gall H, Scherb W, et al.: Arterial anatomy and arteriographic diagnosis of arteriogenic impotence. Cardiovasc Intervent Radiol 1988, 11:195–210.
Kawanishi Y, Lee KD, Kimura K, Kojima A, et al Feasibility of multi-slice computed tomography in the diagnosis of arteriogenic erectile dysfunction. BJU Int 2001, 88:390–395.
Sanchez-Ortiz R, Broderick GA: Vascular Evaluation of ED. In Male Sexual Function: A Guide to Clinical Management. Edited by Mulcahy JJ. Totowa, NJ: Humana Press; 2001: 167–199.
Govier FE, Asase D, Hefty TR, et al.: Timing of penile color flow duplex ultrasonography using a triple drug mixture. J Urol 1995, 153:1472–1475.
Meuleman EJ, Bemelmans BLH, van Asten W, et al Assessment of penile blood flow by duplex ultrasonography in 44 men with normal erectile potency in different phases of erection. J Urol 1992, 147:51–56.
Lue TF, Donatuci CF: The combined intracavernous injection and stimulation test: diagnostic accuracy. J Urol 1992, 148: 61–62.
Montorsi F, Guazzoni G, Barbieri L, et al The effect of intracorporal injection plus genital and audiovisual sexual stimulation versus second injection on penile color doppler sonography parameters. J Urol 1996, 155:536–540.
Pinkstuff DM, Broderick GA: Contemporary management of erectile dysfunction: the challenge for second-generation PDE inhibitors. 3rd Fall Meeting of the Sexual Medicine Society of North America, December 2001. Intl Impot Res 2001, 13: 563.
McMahon CG, Daley J: Correlation of duplex ultrasonography, PBI, DICC and angiography in the diagnosis of impotence. Int J Impot Res 1994, 6: A32.
Sasteschi LM, Montorsi F, Fabris FM, et al Cavernous arterial and arteriolar circulation in patients with erectile dysfunction: power doppler study. J Urol 1998, 159:428–432.
Speel TG, van Langen H, Wijkstra H, Meuleman EJ: Penile duplex pharmacoultrasonography revisited: revalidation of the parameters of the cavernous arterial response. J Urol 2003, 169: 216–220.
Schwartz AN, Lowe MA, Berger RE et al.: Assessment of normal and abnormal erectile function; color doppler sonography versus conventional techniques Radiol Sci North Am 1991, 180:105–109
Merckx LA, De Bruyne RG, Goes E, et al The value of dynamic color duplex scanning in the diagnosis of venogenic impotence. J Urol 1992, 148:318–320.
Teh HS, Lin MB Tsou IY, et al Penile color duplex ultrasonography as a screening tool for venogenic erectile dysfunction. Ann Acad Med Singapore 2002, 31:165–169.
Kayigil O, Metin A: Relaxation degree: a new concept in erectile dysfunction Int Urol Nephrol 2001, 32:391–394
Broderick GA: Contemporary management of erectile dysfunction: the challenge for 2nd generation PDE inhibitors. Intl Impot Res 2001, 13: 545.
Lue TF, Hricak H, Marich KW, et al.: Vasculogenic impotence evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Radiology 1985, 155:777.
Padma-Nathan H: My approach to evaluating erectile dysfunction. Contemp Urol 1995, 7: 53–63.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2004 Springer Science+Business Media New York
About this chapter
Cite this chapter
Broderick, G.A. (2004). Vascular Assessment of Erectile Dysfunction. In: Lue, T.F. (eds) Atlas of Male Sexual Dysfunction. Current Medicine Group, London. https://doi.org/10.1007/978-1-4613-1087-7_3
Download citation
DOI: https://doi.org/10.1007/978-1-4613-1087-7_3
Publisher Name: Current Medicine Group, London
Print ISBN: 978-1-4757-0811-0
Online ISBN: 978-1-4613-1087-7
eBook Packages: Springer Book Archive