MP21-19 AN ALGORITHM TO PREDICT PENILE DOPPLER ULTRASOUND FINDINGS IN MEN WITH ERECTILE DYSFUNCTION

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You have accessJournal of UrologyCME1 May 2022MP21-19 AN ALGORITHM TO PREDICT PENILE DOPPLER ULTRASOUND FINDINGS IN MEN WITH ERECTILE DYSFUNCTION Federico Belladelli, Massimiliano Raffo, Giuseppe Fallara, Edoardo Pozzi, Luigi Candela, Antonio Costa, Christian Corsini, Daniele Cignoli, Nicolò Schifano, Alessia d'Arma, Paolo Capogrosso, Luca Boeri, Eugenio Ventimiglia, Rayan Matloob, Vincenzo Mirone, Francesco Montorsi, and Andrea Salonia Federico BelladelliFederico Belladelli More articles by this author , Massimiliano RaffoMassimiliano Raffo More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Edoardo PozziEdoardo Pozzi More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Antonio CostaAntonio Costa More articles by this author , Christian CorsiniChristian Corsini More articles by this author , Daniele CignoliDaniele Cignoli More articles by this author , Nicolò SchifanoNicolò Schifano More articles by this author , Alessia d'ArmaAlessia d'Arma More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Luca BoeriLuca Boeri More articles by this author , Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Rayan MatloobRayan Matloob More articles by this author , Vincenzo MironeVincenzo Mirone More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002554.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The use of dynamic duplex ultrasound of the penis (DDUP) has been proposed as a second-level test throughout the diagnostic work-up of men presenting with erectile dysfunction (ED). We investigated possible predictor factors for DDUP results. METHODS: DDUP data from 188 patients with ED were prospectively collected to rule out vasculogenic alterations (V-ED) at a single academic centre. Baseline data included: age, cardiovascular risk factors (hypertension, diabetes, total cholesterol levels, waist circumference, regular physical activities), BMI, smoking and alcohol habits and the International Index of Erectile Function – erectile function (IIEF-EF) domain scores. DDUP was performed after intracavernous injection of alprostadil 20 ug and sexual stimulation in all patients. V-ED was defined as a peak systolic velocity (PSV) <35 cm/s and a resistance index (RI) <0.8. We relied on Chi-square Automatic Interaction Detectors (CHAID), a recursive machine learning partitioning algorithm in order to identify risk groups for V-ED. ROC curve was applied to test the accuracy of the prediction for each risk group. RESULTS: Median (IQR) age was 54 (43-60) years and IIEF-EF was 14 (7-20). Of 188, 79 (42%) patients presented with Charlson Comorbidity Index (CCI)≥1. Overall, 57 (30%) and 17 (9%) had hypertension and diabetes, respectively. Median waist circumference was 98.5 (91-105) cm. Of all 164 (87%) patients reported moderate alcohol intake. At DDUP, V-ED was detected in 85 (45%) patients. The CHAID identified three groups: i) age ≤40 years; ii) age >40 years and waist circumference ≤102cm; iii) age >40 years and waist circumference >102cm. We named those groups as low-, intermediate-, and high-risk for V-ED. The risk of V-ED among the groups was: 16.7%, 41.6%, and 64.9%, respectively. ROC curve revealed that this risk classification has a good predictive ability (AUC: 0.67, 95%CI: 0.56-0.72). CONCLUSIONS: Our study challenges current guidelines regarding DDUP. Pending external validation, we propose performing DDUP only in case of intermediate- and high-risk patients, respectively. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e334 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Federico Belladelli More articles by this author Massimiliano Raffo More articles by this author Giuseppe Fallara More articles by this author Edoardo Pozzi More articles by this author Luigi Candela More articles by this author Antonio Costa More articles by this author Christian Corsini More articles by this author Daniele Cignoli More articles by this author Nicolò Schifano More articles by this author Alessia d'Arma More articles by this author Paolo Capogrosso More articles by this author Luca Boeri More articles by this author Eugenio Ventimiglia More articles by this author Rayan Matloob More articles by this author Vincenzo Mirone More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement PDF DownloadLoading ...