Diagnostic value of penile duplex sonography for arteriogenic impotence

Seo, Kyeng Keun; Kim, Young Goo; Kim, Sae Chul

Abstract

Penile duplex sonography with intracorporeal papaverine injection has been proposed as a reliable noninvasive method to evaluate the cavernosal arteries. To provide insight into the clinical value of this test. penile duplex sonography was comparatively analyzed with penile brachial index. nocturnal penile erection and selective internal pudendal pharmacoangiography in 60 patients suggestive of arteriogenic impotence. The duplex sonogram, penile brachial index and angiogram of both cavernosal arteries were evaluated separately and compared each other. Cavernosal arteries were interpreted as normal by duplex scanning if the artery demonstrated a 75% or greater increase in diameter and systolic peak flow velocity of greater than 25 cm/sec after intracorporeal injection of 60 mg or papaverine HCI. There was no significant difference between the degree of arterial dilatation and peak flow velocity on penile duplex sonogram. Arterial dilatation and peak flow velocity did not correlate with nocturnal penile erection and cavernosal arteriogram. But peak flow velocity correlate with penile brachial index. In conclusion. although penile duplex sonography is a useful method to evaluate the cavernosal arteries. it alone can make an error to misdiagnose the arteriogenic impotence. Therefore supplementary tests should be added to the duplex sonography to avoid this error.