Failure to attain stretched penile length after intracavernosal injection of a vasodilator agent is predictive of veno-occlusive dysfunction on penile duplex Doppler ultrasonography

Yafi, Faysal A.; Libby, Russell; McCaslin, Ian; Sangkum, Premsant; Sikka, Suresh C.

doi:10.1111/andr.12073

Cited by 11 publications

(7 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cavernosography revealed a high rate (82.4%) of venous ED among the included patients, which is similar to the rate reported in a previous study conducted by Yafi et al [22]. For the diagnostic conformance of venous ED using cavernosography and CDDU, the 11-15 min interval after ICI had the highest Kappa value (0.761), representing excellent agreement.…”

Section: Discussionsupporting

confidence: 87%

Time-effect of penile color duplex Doppler ultrasound for diagnosing vascular erectile dysfunction

Wang

Liu

et al. 2020

Med Ultrason

View full text Add to dashboard Cite

Introduction: This study aimed to explore the time-effect of color duplex Doppler ultrasound (CDDU) in the diagnosis of vascular erectile dysfunction (ED).Material and methods: Using a self-control study, we included patients who underwent penile CDDU and cavernosography in our hospital. We compared the arterial peak systolic velocity (PSV) of CDDU among different intervals for the diagnosis of arterial ED. We included 357 patients who were under consideration for vascular ED.Results: We found significant differences in all the pairwise comparison of PSV in the 1st (0–5 min), 2nd (6–10 min), 3rd (11–15 min), and 4th (16–20 min) 4 intervals after the injection of prostaglandin E1 (p<0.001), except the 11–15 min vs. the 16–20 min interval (p=0.387). Using cavernosography, 294 patients were diagnosed with venous ED. Compared with other intervals, the diagnosis of CDDU 11–15 min after the intracavernous injection of 20 ug prostaglandin E1 (PGE1) had the best consistency with cavernosography (Kappa=0.761; p<0.001). Compared with other intervals, CDDU at 11–15 min had the highest specificity (93.65%), the highest Youden index (0.85), positive likelihood ratio of 14.46, positive predictive value of 98.54%, negative predictive value of 71.08% and a coincidence rate of 92.16%.Conclusions: Our findings support the increased utilization of CDDU for the diagnosis of both arterial and venous ED. The diagnosis at 11–15 min after intracavernous injection of PGE1 is accurate and stable, which would help to simplify the process and shorten the time of CDDU.

show abstract

Section: Discussionsupporting

confidence: 87%

Time-effect of penile color duplex Doppler ultrasound for diagnosing vascular erectile dysfunction

Wang

Liu

et al. 2020

Med Ultrason

View full text Add to dashboard Cite

show abstract

“…As described previously, penile length and circumference measurements were performed prior to ICI and after reaching peak ICI erection [10]. The penile length was measured from the base of the penis (pubic bone) at the pubo‐penile junction to the tip of glans, in both its flaccid state and following maximum manual stretch.…”

Section: Methodsmentioning

confidence: 99%

Comparative Analysis of Tunical Plication vs. Intralesional Injection Therapy for Ventral Peyronie’s Disease

Yafi

Hatzichristodoulou

Knoedler

et al. 2015

The Journal of Sexual Medicine

View full text Add to dashboard Cite

Introduction Approximately 10% of Peyronie’s disease (PD) patients present with ventral curvatures and, as such, there is a paucity of data describing the optimal approach for treatment. Aim This study aims to compare the outcomes of surgery (tunical plication [TP]) and intralesional injection (ILI) therapy (interferon-α2b) in men with ventral PD. Materials and Methods Retrospective data were collected from two centers: Tulane University (ILI) and Technical University of Munich (TP). Collected variables included patient demographics, pre- and post-treatment sexual function, rigorous penile measurements (curvature, length, and penile vascular findings), and post-treatment outcomes. Results A total of 35 patients with ventral PD (21 ILI and 14 TP) were included in the study. There were no significant differences between the two groups prior to the interventions. There was a significantly better improvement in mean curvature with TP (46.4 degrees) as compared with ILI (9.3), P < 0.0001. TP was also associated with a significantly higher rate of ≥20% improvement in curvature as compared with ILI (100% vs. 67%, P = 0.027). Although there was no significant difference in post-treatment change in Sexual Health Inventory for Men (SHIM) scores between the groups, 36% of the ILI patients noted an improved SHIM score as compared with none in the TP group. Erect penile length was preserved or improved in 67% of the ILI group vs. 14% of the TP group, P = 0.005. Conclusions TP confers a better overall improvement in penile curvature as compared with ILI in patients with ventral PD. Preserved or improved erect penile length and SHIM scores may be observed in patients undergoing ILI.

show abstract

“…This test allows us to see single images, differently from the penile Duplex Doppler ultrasound (PDDU), where Color Doppler images are combined with the grayscale (B-mode) ones. This leads to the visualization of duplex ultrasonography images, needed for simultaneous visualization of the anatomy of the area [8]. Although due to the lack of standardization of the sampling location [9] and cut-off values, a relevant effort was made through decades to identify PCDU waveforms predictive of arterial or venous ED [3].…”

Section: Introductionmentioning

confidence: 99%

Differences in Penile Hemodynamic Profiles in Patients with Erectile Dysfunction and Anxiety

Cannarella

Calogero

Aversa

et al. 2021

JCM

View full text Add to dashboard Cite

Background: Penile echo-color Doppler ultrasound (PCDU) is the gold standard for the diagnosis of arterial erectile dysfunction (ED). Its reliability in patients with anxiety was questioned, due to false-positive results. Aim: To assess the penile hemodynamic response to intracavernous injection (ICI) of alprostadil in patients with anxiety-related ED. Methods: Patients with non-organic ED and a 5-item International Index of Erectile Function (IIEF-5) score ranging between 5 and 7 were enrolled. They were asked to compile the 7-item Generalized Anxiety Disorder (GAD-7) questionnaire to assess the degree of anxiety and were divided according to the GAD-7 score in Group 1 with minimal level of anxiety (n = 20), Group 2 with mild anxiety (n = 20), Group 3 with moderate anxiety (n = 20), and Group 4 with severe anxiety (n = 20). Peak systolic velocity (PSV) and the end-diastolic velocity (EDV) were sampled in all patients, through PCDU in the flaccid state, and 5, 10, 15, and 20 min after ICI of alprostadil at the standard dose of 10 μg. Results: In penile flaccidity, the patients showed a mean PSV of 8.0 ± 4.0 cm/s. The degree of anxiety was found to significantly influence both PSV and EDV at all assessed time-points. Particularly, it was negatively associated with the PSV at time 5 (r = −0.9, p < 0.01), 10 (r = −0.9, p < 0.01), 15 (r = −0.9, p < 0.01), and 20 (r = −0.7, p < 0.01) minutes, and positively with the EDV at time 5 (r = 0.7, p < 0.01), 10 (r = 0.6, p < 0.01), 15 (r = 0.5, p < 0.01), and 20 (r = 0.3, p < 0.01) minutes. Although all patients showed a mean dynamic PSV > 25 cm/s (which excluded an arterial ED according to the current guidelines), a peculiar hemodynamic pattern was found in patients with severe anxiety. In these patients, normal PSV values were reached only after 20 min from ICI, suggesting a “late-responder” profile. Conclusion: If further studies confirm the existence of a distinct hemodynamic profile in patients with severe anxiety, sampling the PSV and the EDV values could be proposed, for detecting patients with severe anxiety-related ED. Dynamic PCDU could be considered an accurate diagnostic test in patients with non-organic ED, since zero false-positive results were found in the present study. PSV in the flaccid state is not able to discriminate between arterial- or non-organic ED.

show abstract

Failure to attain stretched penile length after intracavernosal injection of a vasodilator agent is predictive of veno-occlusive dysfunction on penile duplex Doppler ultrasonography

Cited by 11 publications

References 13 publications

Time-effect of penile color duplex Doppler ultrasound for diagnosing vascular erectile dysfunction

Time-effect of penile color duplex Doppler ultrasound for diagnosing vascular erectile dysfunction

Comparative Analysis of Tunical Plication vs. Intralesional Injection Therapy for Ventral Peyronie’s Disease

Differences in Penile Hemodynamic Profiles in Patients with Erectile Dysfunction and Anxiety

Contact Info

Product

Resources

About