PD27-02 PENILE DOPPLER ULTRASOUND AT A TERTIARY REFERRAL CENTER FOR ERECTILE DYSFUNCTION: WHAT WE LEARNED OVER A 12 YEAR PERIOD.

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I1 Apr 2018PD27-02 PENILE DOPPLER ULTRASOUND AT A TERTIARY REFERRAL CENTER FOR ERECTILE DYSFUNCTION: WHAT WE LEARNED OVER A 12 YEAR PERIOD. Eric Schommer, John Moore, Zachary McNulty, Rishubh Shah, Colleen Thomas, and Gregory Broderick Eric SchommerEric Schommer More articles by this author , John MooreJohn Moore More articles by this author , Zachary McNultyZachary McNulty More articles by this author , Rishubh ShahRishubh Shah More articles by this author , Colleen ThomasColleen Thomas More articles by this author , and Gregory BroderickGregory Broderick More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1353AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The primary aim of our study was to review patient characteristics and color duplex doppler ultrasound (CDDU) results from a single center cohort of greater than 900 patients over a 12 year period. METHODS A total of 970 patients received an intracavernous injection and underwent CDDU from February 2005 to May 2017 by a single urologist with mens health expertise. Phase one included doppler findings prior to visual sexual stimulation and phase two included doppler data post visual sexual stimulation. We retrospectively gathered patient characteristics including age, BMI, previous prostate surgery, hypertension, diabetes, coronary artery disease, hyperlipidemia, smoking history, history of PDE-5 failure, and SHIM score. Penile doppler findings including peak systolic velocities (PSV) bilaterally, primary diagnosis after doppler study, and bilateral resistive index were also gathered. Mild to moderate arterial insufficiency (AI) was characterized as peak systolic velocity ≤35 - 25 cm/sec, severe AI as < 25 cm/sec, and cavernous venous occlusive disease (CVOD) as a unilateral resistive index of <0.9 with PSV >35 cm/sec. RESULTS Over the 12 year period, 970 CDDU studies were done for evaluation of erectile dysfunction (ED) and peyronies disease (PD). The mean age was 57 (range 17-88) and the mean body mass index was 28.9 kg/m2 (range 17.7-68.8). Overall the patient cohort had severe erectile dysfunction as evidenced by mean SHIM (sexual health inventory for men) score of 11.1. 548 (56.5%) men had previously failed a PDE-5 inhibitor. Robotic prostatectomy was previously performed in 46 patients, radical prostatectomy in 45 patients, and an endoscopic prostate procedure in 33 patients. Diagnosis of hypertension was present in 443 patients (45.7%), diabetes mellitus in 166 patients (17.1%), coronary artery disease in 147 patients (15.2%), hyperlipidemia in 400 patients (41.2%), and previous smoking history in 204 patients (27.3%). Overall, 198 patients were diagnosed with AI alone, 236 with CVOD alone, 371 with normal CDDU, and 497 with peyronies disease. Patients could have AI or CVOD in addition to a peyronies diagnosis. 52.3% of peyronies disease referrals had normal CDDU. CONCLUSIONS In our experience patients evaluated at a tertiary referral center for ED are motivated to have a specific diagnosis made. We have utilized evidence based testing for these men with CDDU. The majority of these men do have vasculogenic ED (61.2 %). The second largest group has peyronies disease and CDDU effectively quantifies coexisting vasculogenic ED in these patients. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e557 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Eric Schommer More articles by this author John Moore More articles by this author Zachary McNulty More articles by this author Rishubh Shah More articles by this author Colleen Thomas More articles by this author Gregory Broderick More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...