Hemodynamic evaluation of the penile arterial system in patients with erectile dysfunction using power doppler imaging

Abstract

Objectives. To assess the hemodynamics of the cavernous arteries (CAs) and helicine arteries (HAs) using power Doppler imaging (PDI) in patients with erectile dysfunction (ED). Methods. Forty-two patients with and without a definite vascular component of ED were examined by PDI. The hemodynamic variables of the CAs and HAs were measured after intracavernous injection of 20 μg of prostaglandin E 1. Results. The CAs and HAs were visualized clearly and could be evaluated by PDI after prostaglandin E 1 injection in all patients. The hemodynamic variables of both the CAs and HAs differed between the groups. In the nonvasculogenic group, all 18 patients had normal cavernous arterial flow and achieved a full rigid erection. The mean peak systolic velocity in the HA was 19.5 cm/s on the right and 19.1 cm/s on the left. In the vasculogenic group, 43% of the 14 patients with normal cavernous arterial flow achieved a full rigid erection and had hemodynamic variables comparable to those in the nonvasculogenic group, but 57% failed to achieve a full rigid erection and their mean peak systolic velocity in the HA (8.5 cm/s, P = 0.0065 on the right; and 7.0 cm/s, P = 0.0024 on the left) was lower than in the nonvasculogenic group. Ten patients had reduced cavernous arterial flow and a full rigid erection could not be achieved. The mean peak systolic velocity (7.8 cm/s, P = 0.0009 on the right; and 6.5 cm/s, P = 0.0004 on the left) was lower than in the nonvasculogenic group. Conclusions. PDI is useful for evaluating the hemodynamics of the penile arterial system in patients with ED. Our data suggest that abnormalities of the HA contribute to ED.