MP21-20 EXPLORING ERECTILE HEMODYNAMICS IN MEN COMPLAINING OF HARD-FLACCID SYNDROME (HFS)

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You have accessJournal of UrologyCME1 May 2022MP21-20 EXPLORING ERECTILE HEMODYNAMICS IN MEN COMPLAINING OF HARD-FLACCID SYNDROME (HFS) John Sullivan, Carolyn Salter, Jose Flores, Pat Guhring, Marilyn Parker, and John Mulhall John SullivanJohn Sullivan More articles by this author , Carolyn SalterCarolyn Salter More articles by this author , Jose FloresJose Flores More articles by this author , Pat GuhringPat Guhring More articles by this author , Marilyn ParkerMarilyn Parker More articles by this author , and John MulhallJohn Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002554.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is increasing awareness of a condition, vernacularly termed HFS, in which men complain of subjective and palpable abnormalities in the flaccid penis (hardness, heaviness) often associated with erectile dysfunction (ED). We attempted to define erectile hemodynamic profiles in this population. METHODS: The study population consisted of (i) males ≥18 years of age (ii) who presented with self-diagnosed HFS (iii) who underwent comprehensive history and examination (including genital and lower extremity neurological) and (iv) penile duplex Doppler ultrasound (PDDU). PDDU was performed using redosing of vasodilators. PSV ≥35 cm/s and EDV ≤3 were considered normal. Patients with Peyronie’s disease or a history of intracavernosal injection therapy were excluded. RESULTS: 88 men were analyzed. Mean age was 28±12 years. Median number of vascular comorbidities was zero (0, 1). 66 (75%) had a history of depression or anxiety, 60 of whom had used pharmacotherapy for such at some time and 40 were actively using anxiolytics or anti-depressants at time of evaluation. No patient had a history of neurological conditions and neurological exam was normal in all. Mean duration of symptoms was 14 ± 20 months. Median number of prior physician consultations was 1 (1,4). All complained of impaired erectile function, 50% being incapable of having penetrative sexual relations. 91% had or were using PDE5 inhibitors. On examination all patients had a hypertonic flaccid penis with excellent stretch on traction. At PDDU, median number of penile injections was 2 (1, 3). 50% of men required phenylephrine reversal. All patients had normal PSV with 2/88 having abnormal EDV values, both of whom required reversal. Mean PSV was 45±35 cm/s, mean EDV was 2±11 cm/s. No patient had elevated echogenicity on B-mode scanning. CONCLUSIONS: In this analysis, all men presenting with self-reported HFS had normal hemodynamics and an absence of fibrosis, suggesting the absence of vascular or gross cavernosal smooth muscle structural changes. 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 John Sullivan More articles by this author Carolyn Salter More articles by this author Jose Flores More articles by this author Pat Guhring More articles by this author Marilyn Parker More articles by this author John Mulhall More articles by this author Expand All Advertisement PDF DownloadLoading ...