AVS(Audiovisual Stimulation)-Penogram

Choi, Hyung Ki; Kim, Cheol Soo

Abstract

In an effort to find more comprehensive and general diagnosis of erectile failure, we already have analysed 90 cases and reported the results. After that we added 199 more cases and performed a computer based analysis of total 289 cases in the dynamic changes of penile blood flow during natural physiologic erection after exposure to the audiovisual stimulation. The following results were obtained. 1. In normal volunteers, we were able to achieve uniform penogram findings in all cases with T.T.(Transit Time) ranging 1 to 3 minutes(mean 2.17 minutes), the EPT(Erection Persistent Time) over 30 minutes and no fluctuation phenomena after AVS. 2. Erectile failure group.(2.83 cases) (1) Group I.(108 cases; 38.2%). They demonstrated similar penogram features with the normal volunteers but EPT more than 5 minuets(mean 18.26 minutes) at least. most common causes were psychogenic origin(57 cases). (2) Group II.(175 cases ; 61.8%). Patients were showing abnormal penogram findings, and were divided into following 3 types. a) A type-Impossible type(10 cases ; 3.5%). They failed to show more than 2 fold increase in the maximal radioactivity after AVS when compared to the pre-stimuli level(mean 1.83 times). The underlying causes were identified to be arteriogenic and neurogenic. b) B type-Unstable type(124 cases ; 43.8%). They were unable to sustain erection due to fluctuation(mean 1.83 times). The underlying causes were psychogenic, vasculogenic and neurogenic origins. c) C type-Delayed type(41 cases ; 14.5%). They were showing T.T. more than 15 minutes(mean ; 23.71 minutes), and the underlying causes were arteriogenic, psychogenic and neurogenic origins. Based on these results, we have concluded that AVS-Penogram seems to the most appropriate diagnostic method for screening test and follow-up evaluation after vascular surgery. Through more clinical experience and investigation, and more comparison and analysis with other diagnostic methods, it will be a standard diagnostic approach in the future.