Penile Doppler ultrasonography and elastography evaluation in patients with erectile dysfunction

Abstract

PurposeTo evaluate the relationship between erection grade, erectile function score, Doppler ultrasonography (US) indexes, and elasticity score (ES) according to Doppler US diagnosis in patients with erectile dysfunction (ED).Material and methodsReal-time strain type penile elastography was performed during penile Doppler US examination for 88 patients with ED. The diagnosis according to Doppler US was determined. Erection score according to the Erection Hardness Grading Scale was evaluated. A scoring for erectile function was performed with the International Index of Erectile Function (IIEF-5), and the Sexual Health Inventory for Men (SHIM) was defined. The relationships, according to Doppler diagnosis, of ES, IIEF-5 score, SHIM scale, and erection score were evaluated.ResultsAmong the patients, 50 (57%) had abnormal penile Doppler US findings. According to Doppler US findings, patients were classified as normal (n = 38), borderline for arterial insufficiency (n = 4), arterial insufficiency (n = 5), and venous insufficiency (n = 41). The lowest erection hardness grades and IIEF-5 scores were detected in patients with arterial failure. When compared to the normal group, in terms of ES, the arterial failure borderline group and venous failure group had lower scores, and the arterial failure group had a higher score. However, the only significant difference was obtained in the left cavernous body of the venous failure group.ConclusionsSonoelastography seems to add additional value for determination of stiffness of the penile cavernous body in routine evaluation of ED.

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“…Erectile function was measured using the five-item version of the IIEF-5 and erection hardness grading scale (EHGS) (8). According to the scale, grades 0, 1, 2, 3 and 4 represent 'not enlarged', 'larger but not hard', 'hard but not hard enough for penetration', 'hard enough for penetration but not completely hard' and 'completely hard and fully rigid', respectively.…”

Shear wave elastography as a new, non-invasive diagnostic modality for the diagnosis of penile elasticity: a prospective multicenter study

“… 31 showed that both the elasticity and the viscosity of the CC of the penis correlated with the peak systolic velocity and also viscosity and elasticity correlated negatively with future cardiovascular risk. Altinbas and Hamidi 32 performed real-time strain-type elastography during penile Doppler ultrasound examination in 88 patients with ED, and they were divided in agreement to Doppler ultrasound findings in normal, borderline for arterial insufficiency, arterial insufficiency and venous insufficiency. They found that when compared with the normal group, the arterial failure borderline group and the venous failure group had less stiffness, and the arterial failure group had higher stiffness than the normal group even though a statistically significant difference was recorded in the left CC in the venous failure group.…”

Diagnostic categorization of erectile dysfunction using duplex color doppler ultrasonography and significance of phentolamine redosing in abolishing false diagnosis of venous leak impotence: A single center experience

“…A PSV of <25 cm/s has been correlated with severe arterial disease on angiographic imaging. [ 8 ] Penile Doppler ultrasonography not only enables the arterial waveform to be analyzed but also allows for visualization of stenoses, damped waveforms and high-velocity that may occur as a result of a proximal stenosis elsewhere. Venous incompetence can cause ED through failure of cavernosal engorgement.…”