Abstract
The present study aims to investigate and compare the diagnostic and prognostic value of cavernosography with 320-row dynamic volume computed tomography (DVCT) versus conventional cavernosography in men with erectile dysfunction (ED) caused by venous leakage. A total of 174 patients diagnosed with ED were enrolled and received cavernosography with 320-row DVCT (DVCT group) and conventional cavernosography scans (control group) respectively. The diagnosis, complications, and prognosis of patients were evaluated. The DVCT group provided high-resolution images with less processing and testing time, as well as lowered radiological agent and contrast agent compared with the control group. In the DVCT group, 89 patients who were diagnosed with venous ED had six various venous leakage, namely superficial venous leakage, profundus venous leakage, the mixed type, cavernosal venous leakage, crural venous leakage, and also venous leakage between the penis and urethra cavernosum (9, 21, 32, 6, 18, and 3 cases respectively). Similarly, 74 patients out of the 81 who suffered from venous ED were classified to have superficial venous leakage (11), profundus venous leakage (14), the mixed type venous leakage (26), and middle venous leakage (23). Six out of 25 patients in the DVCT group, had improvements in ED while the remaining 19 achieved full erectile function recovery with no penile fibrosis and erectile pain. Cavernosography with 320-row DVCT is a reliable system that can be used to diagnose ED caused by venous leakage. This is especially useful in accurately determining the type of venous and allows for a better prognosis and direction of treatment.
Highlights
Erectile dysfunction (ED) is been defined as the recurrent or consistent inability to generate or maintain a penile erection of sufficient rigidity for sexual intercourse [1]
Baseline characteristics of patients between the dynamic volume computed tomography (DVCT) and control groups In this investigation, 81 patients received conventional cavernosography and 93 patients received cavernosography with 320-row DVCT
Images produced by cavernosography with 320-row DVCT show smooth, symmetrical, high-density spindle-shaped corpora cavernosa, and strip-like low-density shadows in the space of corpora cavernosa in the DVCT group (Figure 1A and B)
Summary
Erectile dysfunction (ED) is been defined as the recurrent or consistent inability to generate or maintain a penile erection of sufficient rigidity for sexual intercourse [1]. Aging is one main risk factor contributing to the onset of ED, whereby data show a 20–40% occurrence rate in men aged between 60 and 90 years old and 50–100% in men who are between 70 and 80 years old [3]. Other risk factors such as depression, diabetes, heart disease, hypertension, atherosclerosis, high cholesterol, high blood pressure, obesity, and alcoholism are in tight association with ED incidence, whereby vascular disease is found to be the highest contributing factor [4]. Causes of vasculogenic ED include arterial insufficiency (AI, 30%), mixed vascular etiology (10%), and veno-occlusive dysfunction (VOD, 15%), and VOD is a condition that occurs due to an inability to trap blood in the tunica albuginea of the corpora, which results in insufficient compression of the subtunical venules in the phase of full erection [5]
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