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Penile Ultrasound

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Ultrasound of the Male Genitalia

Abstract

Penile ultrasound is commonly used in the diagnostic workup of patients with erectile dysfunction (ED), but also plays an important role by providing an anatomic and functional assessment in a multitude of other conditions including Peyronie’s disease, priapism, penile fracture, penile urethral strictures, urethral stones, or diverticulae, or masses involving deep tissues of the penis. As a component of the evaluation for ED, penile Doppler ultrasound (PDU) is performed to assess the quality of arterial blood flow and sufficiency of veno-occlusive mechanisms, both necessary for adequate erections. More recently, PDU is playing a central role in the early detection of otherwise silent coronary artery disease (CAD) in men presented with ED as their initial symptom. PDU is also an essential component of the assessment of external genitalia in trauma situations. Penile ultrasound provides a readily available, minimally invasive diagnostic modality that evaluates both the structural anatomy and functional hemodynamics.

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Author information

Authors and Affiliations

  1. The Arthur Smith Institute for Urology, Hofstra North Shore-Long Island Jewish Health System, 450 Lakeville Road, Ste. M41, New Hyde Park, NY, 11040, USA

    Bruce R. Gilbert MDPhD

  2. Department of Urology, University of Alabama at Birmingham, Faculty Office Tower 1107; 510 20th Street South, Birmingham, AL, 35294, USA

    Soroush Rais-Bahrami MD

Authors
  1. Soroush Rais-Bahrami MD
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  2. Bruce R. Gilbert MDPhD
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Corresponding author

Correspondence to Soroush Rais-Bahrami MD .

Editor information

Editors and Affiliations

  1. Jewish Health System, The Arthur Smith Institute for Urology, New Hyde Park, New York, USA

    Bruce R. Gilbert

Appendix

Appendix

Patient Instructions for Penile Injection Therapy

I Preparation for Injection

Items You Will Need

  • Alcohol sponges or swaps

  • 1 mL insulin syringe with #28 or #30 gauge needle. These are disposable and not to be reused for a second injection. Disposal should be performed with the cap on the needle so as not to injure anyone disposing of trash.

  • Papaverine/Phentomlamine combination, Prostaglandin E1 or Papaverine/Phentolamine/Prostaglandin combination either pre-drawn by the physician a pharmacist in the syringe, or in a vial to be drawn into the syringe by the patient in the appropriate volume as prescribed by the physician. The medication must be refrigerated and away from light exposure.

Filling the Syringe

  1. 1.

    Check the expiration date of medication. Hold the medication bottle so that your fingers do not touch the rub or stopper.

figure b
  1. 2.

    Using a circular motion, wipe off the top of the bottle with alcohol swab.

figure c
  1. 3.

    Remove the needle cover. Do not allow the need of to touch anything before drawing the medication or before injecting the medication.

figure d
  1. 4.

    Draw an amount of the air is cool to the mountain medication to be injected into the syringe. Push the need of and to the center of the stopper. Push the air into the bottle.

figure e
  1. 5.

    Turn the bottle and syringe upside down. Solely draw the medication into the syringe. Tap the syringe gently to remove the bubbles.

figure f
  1. 6.

    Move the plunger in and out several times while gently tapping the syringe, just removing all air bubbles.

figure g
  1. 7.

    Gently removing the old from the bottle and replace the. The soon the protective and place the filled syringe within easy reach prior to injection.

figure h

II Self-injection Technique

Step 1

Grasp the head of the penis, not the skin, and hold upwards toward the trunk. Position the penis along your inner thigh. Choose the injection site on the side of the penis. Avoid injecting into any visible veins. The crossed hatched areas in the figure below represent the ideal locations to inject into.

figure i

Step 2

Wipe the skin with an alcohol swab.

figure j

Step 3

Pick up the syringe between the thumb and middle finger, like a pen, and push the needle gently but firmly through the skin until the entire need is buried inside the penis.

figure k

Step 4

Holding the syringe, use your thumb to slowly (8–10 s) inject the entire amount of medication. Then remove the needle with from your penis.

figure l

Step 5

Immediately apply pressure on the injection site with another alcohol wipe for at least 2 min. Make sure there is no bleeding.

figure m

Step 6

Dispose of the syringe unit into the puncture-proof receptacle provided.

Step 7

Stand up to allow your erection to develop quickly. You are now ready to start sexual foreplay. You will have a full or action within a few minutes.

Normally, the erection will last anywhere from 30–120 min. If your erection lasts longer than 3 h, you should seek immediate medical attention.

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Rais-Bahrami, S., Gilbert, B. (2015). Penile Ultrasound. In: Gilbert, B. (eds) Ultrasound of the Male Genitalia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7744-0_5

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  • DOI: https://doi.org/10.1007/978-1-4614-7744-0_5

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