You have accessJournal of UrologySexual Function/Dysfunction: Evaluation I (MP27)1 Sep 2021MP27-19 SELECTING PATIENTS FOR PENILE DOPPLER ULTRASOUND IN CLINICAL PRACTICE Paolo Capogrosso, Luigi Candela, Antonio Costa, Walter Cazzaniga, Giuseppe Fallara, Daniele Cignoli, Luca Boeri, Gianmarco Colandrea, Nicolò Schifano, Julian Cornelius, Costantino Abbate, Federico Dehò, Agostino Mattei, Francesco Montorsi, and Andrea Salonia Paolo CapogrossoPaolo Capogrosso More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Antonio CostaAntonio Costa More articles by this author , Walter CazzanigaWalter Cazzaniga More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Daniele CignoliDaniele Cignoli More articles by this author , Luca BoeriLuca Boeri More articles by this author , Gianmarco ColandreaGianmarco Colandrea More articles by this author , Nicolò SchifanoNicolò Schifano More articles by this author , Julian CorneliusJulian Cornelius More articles by this author , Costantino AbbateCostantino Abbate More articles by this author , Federico DehòFederico Dehò More articles by this author , Agostino MatteiAgostino Mattei 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.0000000000002024.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The routine use of dynamic duplex ultrasound of the penis (DDUP) to detect vasculogenic erectile dysfunction (V-ED) has been questioned because of a related patient’ discomfort and costs issues. We investigated clinical factors which could guide the physician in selecting candidates for DDUP in routine practice. METHODS: Data were collected for 119 patients with ED who underwent DDUP regardless of their clinical history, to rule out V-ED at a single centre. Baseline data included: age, comorbidities (as scored with the Charlson Comorbidity Index (CCI)), BMI, recreational habits and the International Index of Erectile Function–6 (IIEF-6). DDUP was performed after intracavernous injection of alprostadil 20 ug and self sexual stimulation. V-ED was defined as a peak systolic velocity (PSV)<30 cm/s ± end diastolic velocity (EDV) of >3 cm/s and a resistance index (RI)<0.8. Logistic regression analysis tested clinical predictors of V-ED. The accuracy of the predictive model was assessed and decision curve analyses (DCA) tested their clinical benefit. RESULTS: Median (IQR) age was 54 (43-60) years and IIEF-6 was 15(8-21). Of 119, 44 (37%) patients had comorbidities (CCI>=1), with cardiovascular disease (CVDs) and diabetes in 13(11%) and 16(14%) patients. Of all, 18(15%) patients were current smokers and 58(49%) had no regular physical activity. At DDUP, median right and left PSV were 36.7 (25.7-43.9) and 36.1 (25.3-44.9) cm/s. V-ED was detected in 50(42%) patients. Age (OR:1.05;95%CI 1.01–1.08; p=0.004) and smoking history (OR:3.33; 95%CI 1.13–9.8; p=0.02) were associated with a higher risk of V-ED, while physical activity was a protective factor (OR:0.43; 95%CI:0.20–091; p=0.03). Conversely, BMI, IIEF-6, CVDs, diabetes and CCI were not associated with V-ED. The model including age, smoking and physical activity had a fine accuracy to predict V-ED (AUC:0.70;95%CI:0.60–0.79). At DCA (fig. 1), the use of those clinical factors to select candidates for DDUP would result in the best clinical strategy if a threshold risk of V-ED>=35% is considered as a reasonable value to trigger the investigation. CONCLUSIONS: Clinical factors including age and lifestyle habits could be used in the everyday clinical practice to better select patients for DDUP, if the use of this test is considered clinically reasonable for patients with >=35% risk of V-ED. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e479-e479 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paolo Capogrosso More articles by this author Luigi Candela More articles by this author Antonio Costa More articles by this author Walter Cazzaniga More articles by this author Giuseppe Fallara More articles by this author Daniele Cignoli More articles by this author Luca Boeri More articles by this author Gianmarco Colandrea More articles by this author Nicolò Schifano More articles by this author Julian Cornelius More articles by this author Costantino Abbate More articles by this author Federico Dehò More articles by this author Agostino Mattei More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Loading ...