MP43-19 A CONTEMPORARY ASSESSMENT OF NORMAL ERECTION PHYSIOLOGY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Basic Research & Pathophysiology I1 Apr 2018MP43-19 A CONTEMPORARY ASSESSMENT OF NORMAL ERECTION PHYSIOLOGY Katherine Cockerill, Ram Pathak, Ciarra Boyne, and Gregory Broderick Katherine CockerillKatherine Cockerill More articles by this author , Ram PathakRam Pathak More articles by this author , Ciarra BoyneCiarra Boyne More articles by this author , and Gregory BroderickGregory Broderick More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1418AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Classic studies using invasive caversonometry have associated a rigid erection with sustained intracavernous pressures > 80-90 mm Hg with erection pressures reaching supra-diastolic pressures during activation of bulbocavernous muscle contraction associated with pelvic stimulation. The contemporary assessment of erectile complaints relies on non-invasive color duplex Doppler ultrasound imaging (CDDU). The CDDU parameters associated with rigid erection are End Diastolic Flow Velocity = 0 (EDV0) or EDV reversed (EDVr), when intracavernous pressures equals or exceeds the diastolic blood pressure, respectively. The aim of our study is to identify age-specific diastolic blood pressure (DBP) parameters for patients who achieved normal rigidity following penile injection of Alprostadil associated with EDV0 or EDVr during CDDU. METHODS We retrospectively reviewed 97 men complaining of erectile dysfunction (ED) who demonstrated normal/sustained rigidity. Blood pressure measurements were recorded at the time of CDDU. Other parameters recorded were Peak Systolic Velocity, Resistive Index, EDV, age, BMI, co-morbidities and duration of erectile dysfunction complaints. RESULTS A total of 97 patients with a median age of 57 years and a mean BMI of 26.6 underwent CDDU. All patients achieved rigid erection following PGE1 injection; all but three patients required alpha-adrenergic injection for erection reversal at 60 minutes. Fourteen patients were classified as EDV0 (18.5%) and 83 patients were classified as EDVr (85.5%). Twenty-nine patients (29.9%) had a diagnosis of hypertension. The mean DBP at time of CDDU was 76.7 mm Hg (with SD = 10.7). The mean diastolic blood pressure between men with EDV0 and EDVr was not significantly different (79.7 vs. 75.8 mm Hg, p = 0.13). For patients age <50 years with EDV0, the median DBP was 79 with interquartile range (71, 83). For patients age > 50 years with EDV0, the median DBP was 85 with IQR (73, 89). For patients age < 50 years with EDVr, the median DBP was 76 with IQR (70, 81). For patients age > 50 years with EDVr, the median DBP was 78 with IQR (66, 84). CONCLUSIONS Our study suggests that the previously established parameters for intracavernous pressure >80-90 mm Hg for normal erection may be too high. We found mean diastolic blood pressures of 75-79 mmHg in men complaining of ED who had vascular normal erections following intracavernous Alprostadil. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e586 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Katherine Cockerill More articles by this author Ram Pathak More articles by this author Ciarra Boyne More articles by this author Gregory Broderick More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...