Analysis of Duplex Ultrasonography Flow Parameters against Time in Vasculogenic Impotent Patients

Chung, Woo Sik; Nathant, Harin Padma

Abstract

To evaluate the effect of time factor on the duplex flow measurements of the cavernosal artery we examined 30 patients with suspecting vasculogenic impotence by color flow duplex ultrasonographic evaluation. The cavernosal artery peak systolic flow velocity (PSV), end diastolic flow velocity ( EDV) and resistance index (RI) were determined bilaterally at preinjection, and 5, 10 and 15 min. following the intracavernosal injection(ICI) of PGEl(10ug) and phentolamine (0.2mg) mixture. We classified the patients based on the underlying vasculogenic status into normal (NL group; n=8), arteriogenic impotence with or without venogenic incompetency (AI group; n=11) and venogenic incompetency alone (VI group; n=11). The PSV in NL group was greatest at 5 min. postinjection (45.8+/-12.0cm/s) and declined significantly with time (30.0+/-5.8 cm/s) (p <0.06 ) and also significantly greater than the value obtained by the AI group at each time interval (p<0.01) with the greatest difference at 5 min. post injection. The EDV in NL group was low (0.75+/-0.96 cm/s) at preinjection and increased initially postinjection to 7.5+/-7.9 cm/s at 5 min. postinjection but then declined significantly (p<0.05). The EDV in VI group was significantly greater than that of NL at each time intervals (p<0.05) with the greatest value recorded at 10 min. post injection (l5.0 =5.5 cm/s). The RIs in all the group did not vary with time following ICI but that of NL was significantly lower than that of VI at each time intervals (p<0.01 ). Our data suggest that serial measurement of flow parameters, especially EDV as the indirect marker of veno-occlusive function, is necessary for the comprehensive understanding of hemodynamic vascular process of vasculogenic impotence since the duplex ultrasonographic flow parameters dynamically interact against time following ICI.