Diagnostic accuracy of Doppler ultrasound technique of the penile arteries in correlation to selective arteriography.

Department of Dermatology, Federal Army Hospital, Ulm, FRG.
CardioVascular and Interventional Radiology (Impact Factor: 2.07). 09/1988; 11(4):225-31. DOI: 10.1007/BF02577007
Source: PubMed

ABSTRACT In 63% of 265 patients with erectile dysfunction a relevant arterial inflow disturbance was found by Doppler ultrasound examination. Correlation between Doppler and arteriography in 58 patients showed an accuracy of 95% in detecting penile arteries and an accuracy of 91% in discovering a pathological arterial pattern (arterial anomaly or arteriosclerotic obstruction). In 15 patients the arterial inflow was measured additionally by Doppler ultrasound technique after intracavernosal injection of vasoactive drugs (IIVD) (7.5 mg papaverine and 0.25 mg phentolamine). This technique proved to be more reliable than in the flaccid state and markedly facilitated localization and assessment of pathological changes of the cavernosal arteries.

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    ABSTRACT: A multidisciplinary study was performed on 200 consecutive patients with erectile dysfunction more than 1 year in duration, which included a standardized intracavernous injection of a vasoactive substance mixture (15 mg. per ml. papaverine plus 0.5 mg. per ml. phentolamine). The multidisciplinary findings correlated well with the intracavernous dose needed for full erection. The group without pathological hemodynamic findings (36 patients) needed an average of 0.67 ml. and the group with pathological inflow (107) needed an average of 1.07 ml. In the venous insufficiency group (57 patients) only 18 achieved full erections with an average of 2.1 ml. (39 achieved tumescence only to 3 ml.). The results show that standardized intracavernous injection of a vasoactive substance mixture is a useful method to evaluate penile hemodynamics. This pharmacological test appears to be effective in the differential diagnosis of nonvascular and vascular erectile dysfunction.
    The Journal of Urology 05/1988; 139(4):734-7. · 4.47 Impact Factor
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    ABSTRACT: The past decade has seen a better understanding of the physiology of erection and the pathophysiology of impotence as a result of considerable innovative research. These advances also introduce a new era in the diagnosis and treatment of impotence. Many functional tests and effective medical and surgical treatments are now available. With the sudden explosion of these many tests and therapies, clinicians are often confronted by questions such as: What constitues an adequate workup? What is the treatment of choice of arteriogenic impotence? Is nocturnal penile tumescence testing necessary? Is penile arteriography necessary? Over the past several years, the author has been using a patient's goal-directed approach to the diagnosis and treatment of impotence. This approach is based on (1) the most recent advances of diagnostic technique and therapy of impotence and (2) the patient's physical and mental health, motivation, and goal. This article briefly summarizes this practical patient's goal-directed management of impotence.
    World Journal of Urology 01/1990; 8(2):67-74. DOI:10.1007/BF01576350 · 2.67 Impact Factor
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    ABSTRACT: The intra- and inter-observer variation in the measurement of the penile brachial index (PBI) was prospectively assessed in 30 patients. An appreciable error was discovered that cast doubt on the reliability of the measurements. Up to 20% of patients deemed normal by one observer would be deemed abnormal by a second. The PBI appears to be an inaccurate and poorly reproducible test of penile blood flow which can lead to a false diagnosis and subsequent management of impotent patients. There would appear no justification for the continued use of the penile brachial index in the assessment of erectile dysfunction.
    British Journal of Urology 09/1990; 66(2):202-4. DOI:10.1111/j.1464-410X.1990.tb14904.x
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