In the management of the acute penis, cavernosography should be performed first and the treatment policy should be determined from the radiological findings. Conservative therapy should be chosen only when the corporeal bodies are intact.
This prospective study was designed to compare the parameters obtained by color Doppler ultrasound to cavernous artery occlusion pressure measured by dynamic pharmacoinfusion cavernosometry in evaluating arterial components of erectile dysfunction. Four indexes were determined as parameters of sonography to indicate arterial competence. Indexes 1 and 2 reflected peak systolic velocities with respect to the cut-off values 25 and 30 cm/s after pharmacological stimulation with 60 mg papaverine hydrochloride respectively. Index 3 was the percentage of diameter changes in cavemosal arteries which was expected to be > 75%. The sum of the percents of increases in diameters of both cavemosal arteries which should be > 200, formed index 4. The sensitivity, specificity, positive predictive value and accuracy rates were 76, 100, 100 and 90% for index 2. These values were 50, 100, 100 and 71% for index 1. Very low statistical values were obtained for indexes 3 and 4. Although the gold standard in the diagnosis of arterial impotence is pharmacoangiography, color Doppler sonography using the parameter peak systolic flow rate > 30 cm/s may be a reliable, easily obtained, noninvasive technique for evaluating arterial components of erectile dysfunction.
The aim of this prospective study was to compare the effectiveness of colour Doppler ultrasound and testicular scintigraphy in the differential diagnosis of acute scrotum. Ten patients were investigated by clinical examination initially and by both techniques afterwards. Scintigraphy was performed in a blind fashion. According to the findings, 3 patients were categorized as acute ischaemia and 7 as inflammation. The 3 patients diagnosed as ischaemia underwent surgical exploration. Both imaging techniques predicted ischaemia (100%). In the inflammation group conservative therapy and follow-up were chosen. Ultrasonography alone established the correct diagnosis in 7/7, whereas scintigraphy in 5/7 of the patients.
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