MP51-19 COLOR DUPLEX DOPPLER ULTRASOUND (CDDU): CAN WE CATEGORIZE CAVERNOUS VENOUS OCCLUSIVE DISEASE (CVOD) AS MILD, MODERATE AND SEVERE?

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation II1 Apr 2015MP51-19 COLOR DUPLEX DOPPLER ULTRASOUND (CDDU): CAN WE CATEGORIZE CAVERNOUS VENOUS OCCLUSIVE DISEASE (CVOD) AS MILD, MODERATE AND SEVERE? Ram Pathak, Russell Chavers, Bhupendra Rawal, and Gregory Broderick Ram PathakRam Pathak More articles by this author , Russell ChaversRussell Chavers More articles by this author , Bhupendra RawalBhupendra Rawal More articles by this author , and Gregory BroderickGregory Broderick More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1756AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cavernous venous occlusive disease (CVOD) is defined as a failure to maintain adequate erections despite appropriate arterial inflows and can be non-invasively diagnosed with Color Duplex Doppler Ultrasound (CDDU). The key to making this diagnosis is to identify men with normal cavernous arterial inflows, who fail to achieve rigid erection. The aim of our study was to evaluate the relationship between arteriogenic risk factors of ED and CVOD and determine if it is possible to grade the severity of CVOD with non-invasive Doppler metrics. METHODS A retrospective review was conducted on patients who underwent analysis by CDDU from January 2010 to June 2013. Resistive Indices (RI) were calculated using Peak Systolic Velocity (PSV) and End Diastolic Velocity (EDV) values by the following formula: RI=(PSV-EDV)/PSV. Patients were sub-classified based on the following CDDU parameters: Pure-group (Right and Left pre- and post-PSV≥35cm/s), Intermediate group (Right and Left pre- or post-PSV≥35cm/s), and mixed group (Right or Left pre- or post- PSV≥35cm/s). RESULTS A total of 89 patients, with a mean age of 60 (19-86), mean BMI of 26.5 (19-39.3), and a mean age of ED onset of 52 (13-80) satisfied the criteria of pure and intermediate group (n=75 and n=14). Of the pure and intermediate groups, arteriogenic risk factors were not well represented: hypertension (10%), diabetes mellitus (12%), heart disease (10%), smoking (16%), and hyperlipidemia (44%). When comparing the pure group to the intermediate group plus the mixed group, the median age and median age of ED onset favored younger patients in the pure group (60 vs. 63, p=0.043 and 52 vs. 56, p=0.017). When sub-stratifying the pure group into tertiles, the following RI cutoffs were discovered: mild (81.6-94.0), moderate (72.6-81.5) and severe (59.5-72.5). With these three group's comparison, co-variates such as post-PSV right (p = 0.032), post- PSV left (p= 0.003), average post-PSV (p = 0.002), and SHIM score categories (SHIM scores: 1-10 vs. 11- 20, P = 0.030) were statistically significantly different. CONCLUSIONS Unlike arteriogenic ED, the etiology and risk factors for CVOD remain indeterminate and further research into this field is critical. The data does support a correlation between CVOD and age, with younger patients more likely exhibiting CVOD. The pure group analysis supports a correlation between SHIM score and RI value and provides an evidence-based classification of CVOD as mild, moderate or severe. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e627 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ram Pathak More articles by this author Russell Chavers More articles by this author Bhupendra Rawal More articles by this author Gregory Broderick More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...