Could Standardized Cavernosometry be Helpful in Therapeutic Management of Veno-Occlusive Dysfunction?

Abstract

Purpose Due to the lack of a gold standard for performing cavernosometry, we selected 30 patients with veno-occlusive dysfunction to evaluate the internal relationships of cavernosometric parameters and their reliability for therapeutic decisions. Materials and Methods Cavernosometry was performed after injection of 20 to 40 microgram of prostaglandin E1. Maintenance flow rates, intracavernous pressure decay following cessation of flow and intracavernous pressure changes after compression maneuvers were the main parameters considered. Results Cavernosometric results were standardized as grade 1--7 patients with maintenance flow rate less than 20 ml. per minute (mean 18 plus/minus 2.5) and intravernous pressure decay 27.5 plus/minus 15 percent, grade 2--11 with maintenance flow rates significantly lower (p less than 0.001) than grade 1 (mean 37 plus/minus 11 ml. per minute) and intracavernous pressure decay 33 plus/minus 20 percent, and grade 3--12 with only recorded induction flows greater than 70 ml. per minute and intracavernous pressure less than 50 mm. Hg. A strong statistical correlation (p less than 0.01) was noted between maintenance flow rate and percent of intracavernous pressure decays. Conclusions These parameters allowed us to choose different therapies, such as complex venous surgery, mixed pharmacotherapy or prosthetic implants. Good sexual function was restored in 85 percent of the cases. We can conclude that our model of standardized cavernosometry has made easier the therapeutic choices in patients who do not respond to intracavernous drugs.